LIBRARY OF CONGRESS. 



Shelf if>.„. 

i? §4 

UNITED STATES OF AMERICA. 






-1 



PAINLESS CHILDBIRTH; 



-OR- 



Healthy Mothers, 



HEALTHY CHILDREN. 



A BOOK FOR AIL WOMEN. 



V 






/} 



y 



BY JOHN H. DYE, M. D., 

BUFFALO, N. Y. 



O J 



17 60*7 



THE THIRD EDITION, REVISED AND ENLARGED. 



SILVER CREEK, N. Y. : 

BROWN, ELLIOTT & SPEARS, 

1884. 






Entered according to an Act of Congress, in the year 1883, by 

JOHN H. DYE, M. D., 
In the Office of the Librarian of Congress, at Washington, D. C. 



Entered according to An Act of Congress, in the year 1882, by 

JOHN H. DYE, M. D., 
'In the Office of the Librarian of Congress, at Washington, D. C. 



Entered according to An Act of Congress, in the year 1879, by 

JOHN H. DYE, M. D, 
In the Office of the Librarian of Congress, at Washington, D. C. 



PUBLISHERS' NOTICE 

TO FIRST EDITION. 



Some two years since the author prepared the 
manuscript of this little work for publication as a 
serial in the Popular Medical Monthly, a journal of 
which he was then the editor and proprietor, * Cir- 
cumstances resulting in the sale of the paper and 
its subsequent suspension prevented him from car- 
rying out his design. We were at the time doing 
the typographical work of the 31onthly, and the 
manuscript was placed in our hands. Being inter- 
ested in the subject we were led to read the manu- 
script and finding so much in it that was meritorious, 
and knowing the reliability of the author as a pro- 
fessional gentleman, we requested the privilege of 
publishing the serial in book form, and though it 
had not been prepared with the same care as if it 
had been intended for publication in book form, he 
consented in the hope that it might be a means of 
relieving the suffering of womankind. The man- 
uscript was hastily prepared amid the cares of a 
busy practice, and though it may present many lit- 
erary defects, we trust the motives that led to its 
production, will secure the reader's forbearance. 



vi PAINLESS OBILDBIRTH. 

After obtaining the author's permission to publish 
Painless Childbirth, circumstances caused us to 
defer it until the present. In presenting it to the 
public we trust it will be received for what it is 
worth, and believe that much suffering will be 
avoided by attention to the instructions it offers. 

SPEARS & BROWN. 
Silver Creek, N Y., January 1st, 1880. 



PUBLISHER'S NOTICE 

TO SECOND EDITION. 



The cordial reception extended to the first edi- 
tion of Painless Childbirth by the press, the 
medical profession, and the public, together with 
the rapid sale and constantly increasing demand, 
are to the author and publisher alike, the most 
gratifying evidences of its necessity; while the 
numerous letters received from those who have 
been benefitted by its precepts — who by following 
the instructions within its pages, have escaped the 
suffering experienced at previous confinements — 
afford satisfactory proof of its practical value to 
woman. 

The demand for a second edition has induced 
the author to make a careful revision, and such 
new matter has been added as was needed to make 
the original text more perfect. 

A new chapter has been added to the present 
edition, on "Diseases of Women." While this 
chapter is not necessarily a part of the original 
idea, the numerous solicitations, from all quarters, 
for the production of a treatise on this subject, has 
induced the author to embody in a chapter his 



viii PAINLESS CHILDBIRTH. 

ideas of the treatment of many of those diseases to 
which woman is liable, and include it in this work, 
believing it will fill the void and make the book in 
every sense a ladies' manual. 

Although but little over a year has elapsed since 
the appearance of the first edition, many have sub- 
mitted its teachings to the crucial test of experience 
with most happy results, Many letters of inquiry 
about professional matters have been received. 
Such communications in future should be addressed 
to the author. 

The remedies advised throughout the following 
pages may be found in nearly all first-class drug 
stores in the country, or may be obtained by drug- 
gists for their patrons. 

The present work, we feel certain, will be more 
valuable than at first, Invalid women are to be 
found everywhere, as well as those who would 
avoid the perils and pains of childbirth and to all 
such we most confidently submit it. 

0, E. BROWN. 
Silver Greek, N. K, May 1st, 1882. 



PUBLISHERS' NOTICE 

TO THIRD EDITION. 



The imprint on the first edition of Painless 
Childbirth bore the date of 1880. But one thou- 
sand copies were then printed. As an experiment 
that number was sufficient. This subject, so vital, 
and fraught with such interest to every member of 
the human family, had never before been treated 
in popular language, and at the same time in a 
strictly scientific manner, for the benefit of 
the masses, and to obtain recognition for such a 
book on its merits, was no slight task. The first 
sales were necessarily slow, but the publishers, hav- 
ing faith in the theories of the author, whom they 
had known for some years as a successful practi- 
tioner, not only in obstetrics, but in all other 
branches of practice, persevered, and the result has 
been that their estimate of it was correct. 

The first edition, which had been hastily pre- 
pared, was revised by the author, and more careful 
study and deliberate thought, befitting the import- 
ant subject, was bestowed upon it, and a second 
edition brought out. To make this volume a more 
complete book for all women, another chapter on 



X PAINLESS CHILDBIRTH. 

diseases peculiar to their sex was added, upon 
which subject the author was equally well qualified 
to write. A larger edition was then printed and 
its merits becoming more widely known, its sale 
was rapid. 

Preparations for a third edition were almost im- 
mediately begun on a larger scale, and this volume 
is the result. As valuable as the work then was, it 
become apparent that to make it of the highest 
practical value as a family councilor and guide, 
one thing more was necessary, and that was a chapter 
on the diseases of children, That chapter was ac- 
cordingly added. It has been written in the same 
careful manner as the preceeding chapters, and is 
submitted by the publishers with the same faith in 
its practical utility 

To women we believe this work to be of great 
value. It teaches the mother that the performance 
of her natural functions are not necessarily painful, 
nor attended with subsequent suffering ; that ma- 
ternity is not a curse but a blessing, when she lives 
in accordance with the laws of life and health. 

To the sterile, it points out the way to find relief; 
to the diseased the means of cure, or a possibility 
of greatly ameliorating their condition. 

To little children — the coming generation — 
whose wants are so few, yet hard to understand, it 
will also prove a blessing. It points out to their 
anxious mothers the manner of rearing their off- 
spring so as to escape disease, or where there is no 



PUBLISHERS' NOTICE. xi 

escape, the best means of cure, tnereby greatly in- 
creasing the number of healthy mothers and healthy 
children in the future, and consequently raising 
higher- the standard of both mental and physical 
manhood of each succeeding generation. 

To the judgment of the mothers of the land we 
must respectfully submit this volume, willing that 
its success or failure should rest with so critical, yet 
just a jury. 

BROWN, ELLIOTT & SPEARS 

Silver Creek, June 1st, 1884. 



CONTENTS. 



CHAPTER I. 

SEXUAL ATTRIBUTES. 

Co-existent with Human Existence — The same throughout all 
Ages — Love Fulfills both Divine and Human Laws — The 
Difference Between Sexuality and Sensuality — It is a Man's 
Duty to Comprehend the Laws of his Being, for in Knowl- 
edge there is Safety — Ignorance will not Protect Him from 
the Penalty of Broken Laws — Keason should Govern His 
Acts — Should Govern His Passions Instead of Letting them 
Govern Him — Neither Sex is Complete in Itself — The At- 
traction of the Sexes the Basis of Marriage — Which Loves 
Most, Man or Woman — Sexual Passion — Not Essential to 
Reproduction — Mental, Moral, and Physical Influences of 
the Mother Upon the Unborn — Transmission of Vital and 
Other Characteristics — The Highest and Holiest Duties of 
Earth Consigned to Woman — Discretion — Universality of 
Definite and Well-regulated Laws — Pain, the Result of Hav- 
ing Broken Some Law — Unconscious Transgression — Like 
Begets Like 17 

CHAPTER XL 

MATERNITY. 

Woman's Legitimate Object — The Highest and Holiest to which 
She Can Aspire — What* Maternity Implies — Its Beginning 
and End — Early Development of Characteristic Traits — Ma- 
ternity Encouraged by the Ancients — All Women are Not 
Fit to Become Mothers — How the Transmission of Disease 
may be Favored or Opposed — Matrimonial Selections — 
Woman, Instead of Legislatures, Should Control Her Func- 
tions — How Our Civil Laws Operate — Abuses of Reproduc- 
tion — Opinions of Authors — The Confliction of Social and 
Natural Laws — Laws Against Preventing Conception — As 
Many Sterile Women W ant Children as Fertile Ones Want 
to Prevent Them — A Mistake of the Newly-Married — The 
Proper Age fo r Marriage, and its Influence on Mother and 
Child — Symptoms of Conception — Mothers' Marks — How 
Produced, How Prevented — Longings — Meddlesome Busy- 
bodies — The Plan of the Ancient ^Greeks— Who Should 
INouriMi the Child. •«, 4.,««< *<<»••• i #•<•*< i < i •<<•• 1 1-< « r*M 



CONTENTS. x iii 

CHAPTER III. 

IS PAIN NECESSARY ? 

The Answer to an Important Question — Has the Almighty a 
Special Design in Afflicting Woman? — If the Descendants of 
Adam Escape Pain, why not the Descendants of Eve V — Spe- 
cial Providences — Efficacy of Prayer — The Performance of 
Healthy Functions Painless — Childbirth is Xatural, and 
should be Painless — Pain a Sign of Disease — All Women do 
not Suffer — Uncivilized Usually Escape — Why? — Instances 
— Obstetrical Literature Nearly Silent — Pain is Unnatural 
and Unnecessary 46 

CHAPTER IV. 

CAUSES OF PAIN. 

Unhygienic Customs — Physical Conditions — Social Influences — 
Slavery of Different Stations of Life Contrasted— Irritable 
Nerves — Curvature of Spine — Malformations — Tight Lacing 
— Shape of Pelvis — Female Diseases — Improper Treatment 
— Errors — Marital Relations — How the Condition of the 
Child Affects the Mother — Its size — Hardness of its Bones 
— All these Causes can be Rendered Inoperative 58 

CHAPTER V. 

HYGIENIC MANAGEMENT. 

The Objects of Hygiene — How Surroundings Affect Pregnant 
Women — How She Must Conduct Herself — What Exercise 
Best, and How and When to Take it — Turning the Room 
Out Doors to Air it — The Difference between Bathing and 
Soaking — What Kind of Baths are Best, their Properties, 
etc.— The Sitz Bath — Sleep — Dress — The Spartan Law — 
How Sexual Influences Affect both Mother and Child— All 
Pain, Difficulty and Danger Unnatural 70 

CHAPTER VI. 

DIETETIC MEASURES. 

Composition of the Different Kinds of Food — How the Mother's 
Food Affects Childbirth— The First Experiment and How it 
Resulted — A Very Liberal Dietary— Food that Con1 
Phosphate of Lime 



x i v PAINLESS CHILDBIBTH. 

English Lady's Experiment— Must the Mother Eat for Two ? 
The Extra Amount of Nourishment Required 81 

CHAPTER VII. 

REMEDIAL TREATMENT. 

Diseases Must be Cured — An Indian Tradition — What the 
Squaws do — Squaw Vine — A Favorite Preparation and What 
it Cures— The Properties of Blue Cohosh— Its Power to 
Prevent Pain and Miscarriage— Proof that Remedies Pre- 
vent Painful Labor— Mothers' Cordial— Experience of Phy- 
sicians—The Value of Black Cohosh— How these Medicines 
are to be Used— Management of Constipation— The Kidneys 
Must be Kept Healthy— What Causes Morning Sickness— 
The Fallacy of its Necessity— Shall Longings be Gratified 
or Not— Flatulence and Colic— Varicose or Knotted Veins- 
Heartburn— Piles— Shall Diarrhoea be Checked — Other 
Symptoms— The Sleeping Room— Pressure of the Womb on 
Veins— Abortion— Erroneous Idea— How Maternal Respon- 
sibilities are Evaded— Legal Consideration— Is the Crime 
Justifiable— Prevention of Conception or Abortion— It is 
Murder— Its Effect upon the Woman— Unintentional Causes 
—Premonitory and Actual Symptoms — Hemorrhage the 
Greatest Immediate Danger — My First Case— Preventive 
Measures and When Necessary— Nervousness— Sore Nipples 
Leucorrhoea— Important Advice— False Pains Distinguished 
" from True Ones— Intense Suffering from Irritable Blad- 
der 91 

CHAPTER VIII. 

ANESTHETICS. 

A Priceless Boon and Perfectly Safe— Accidents Among Dentists 
—Theoretical Objections not Sustained in Practice— The 
Degree of Insensibility Desired— Should Other Plans Fail, 
this will make Labor Painless— Who Shall Take Them and 
Who Shall Not— How Long Continued— Views of Physi- 
cians—Why this Chapter is Introduced 142 

CHAPTER IX. 

MANAGEMENT OF LABOR. • 

The Period when Labor Should Occur— Code Napoleon— In- 
stances of Protracted Labor— Preparations for Labor— Pre- 
monitory Symptoms— Indications of Labor— True and False 



CONTENTS. XV 

Pains — Management After it has Begun— Remedies for Rig- 
idous — Encouragement — Progress, etc. — Ineffectual Labor — 
How Overcome— Flooding — The Cord — The Afterbirth — 
Care of Mother and Child — Learning the Child to Nurse — 
After Birth— Superstitions— Disposal 154 

CHAPTER X. 

MANAGEMENT AFTER BIRTH. 

Look after the Mother's Rest — Involution of the Uterus— Diet 
of the Mother — The Lochial Discharge — Danger of Neglect 
— When it is Unnatural what is to be Done — After-pains — 
Remedies — Attention to the Bladder — The Bowels — Bloating 
— Milk Fever — The Nipples and Breasts — Nursing Sore 
Mouth — Remedies — Dosing and Stuffing the Young Eminent 
as Soon as it is Born — Nursing — Why it Should be Done — 
Milk for the Child — A Very Important Matter — Regulating 
the Sleep of the Child — Proper Food for Children — Wean- 
ing — Dress and Bathing — Moral Considerations — Medicine 
for the Baby — Bowels — Jaundice — Urine — Sore Eyes — Pre- 
scriptions — Vomiting — Diarrhoea — Remedies — Colic — Rem- 
edies— Teething— Its Troubles and Remedies 177 

CHAPTER XL 

STERILITY. 

A Divine Mandate — The Consummation of Love but Half At- 
tained — Professional Confidences — Quacks and Marriage 
Guides — Interesting Considerations — History — Causes of 
Sterility — Hymen — What its Presence or Absence Indicates 
— The Woman Blamed — Displacements of the Uterus — Uter- 
ine Tumors — How they Act as Causes and who are to Man- 
age them — Deformities of the Uterus— Stricture — Chronic 
Inflammation — Leuchorrhoea — Dysmenorrhea — Menstrual 
Derangements — Ovarian and Uterine Debility— Sexual Ex- 
cesses and Apathy— r Ovarian Diseass — Late Marriages — 
Sometimes the Husband is to Blame if Marriage is Unfruit- 
ful — Temperamental Incompatibility — Other Causes — Some 
not to be Considered — Relations of Society — When a Wo- 
man is Sterile who is to Blame , 218 

CHAPTER XII. 

DISEASES OF WOMEN. 
Social Customs Cause Disease — Menstruation — Its Disorders — 



xvi PMNLBS8 CHILDBIRTH. 

Ammenorrhoaa — Suppression — Retention — Causes — Symp- 
toms — Treatment — Prescriptions — Anemia — Plethora — Ir- 
regular Menstruation — Painful Menstruation — Characters — 
Treatment — Prescriptions — Profuse Menstruation — Causes 
— Treatment — Vicarious Menstruation — Leucorrhcea — 
Causes — Symptoms — Treatment — Chronic Inflammation of 
the Womb — Causes — Symptoms — Treatment — Constitu- 
tional — Local — Persistence Needed — Prescriptions — Ulcera- 
tion — Symptoms — Treatment — Caustics — Healing Applica- 
tions — Displacements — Different Forms of — Different 
Symptoms — Causes — Treatment General — Local — How to 
Remove — How to Cure — Acute vs. Chronic Displacement— 
Sub-Involution — Character — Causes — Dangers — Treatment 
— Uterine Tumors — Different Varieties — Diagnosis — Re- 
moval — Cancer of the Womb — Change of Life — Symptoms 
Neglected — Effect it Produces on Future Health — Manage- 
ment — Remedies — Conditions Considered — Uterine Stricture 
— Cure — Vaginismus — How it Affects Domestic Relations — 
Causes — Treatment — The Ovaries — Their Importance — 
Their Diseases — Causes — Treatment — Ovarian Tumors — The 
Breasts — Their Double Function — Diseases — Inflammation 
— Abcess — Treatment — Wasting — Causes — Non-Develop- 
ment — Excessive Growth — Tumors — Cancers — Diagnosis — 
What to Do 249 

CHAPTER XIII. 

DISEASES OF CHILDREN. 

Mortality — Gradation of Doses — General Signs — The Counte- 
nance — Attitude and Gesture — The Cry — The Discharges— 
The Circulation — The Temperature — Odors — The Tongue — 
Excoriations and Ulcers — Vomiting — Convulsions — Aptha? 
— Colds — Influenza — Croup — Pneumonia. — Chronic Pneu- 
monia — Consumption ■ — Asthma — Whooping Cough — ■ 
Mumps — Sore Throat — Quinsy — Diphtheria — Cerebro- 
spinal Meningitis — Small Pox — Chicken Pox — Measles — 
Scarlet Fever — Erysipelas — Diarrhoea — Dysentery — Acute 
Intestinal Catarrh — Cholera Morbus — Cholera Infantum — 
Ephemeral Fever — Worms 318 



CHAPTER I. 



SEXUAL ATTRIBUTES. 

Co-existent with Human Existence — The same throughout all 
Ages — Love Fulfills both Divine and Human Laws — The 
Difference Between Sexuality and Sensuality — It is a Man's 
Duty to Comprehend the Laws of his Being, for in Knowl- 
edge there is Safety — Ignorance will not Protect Him from 
the Penalty of Broken Laws — Reason should Govern His 
Acts — Should Govern His Passions Instead of Letting them 
Govern Him — Neither Sex is Complete in Itself — The At- V 
traction of the Sexes the Basis of Marriage — Which Loves 
Most, Man or Woman — Sexual Passion — Not Essential to 
Reproduction — Mental, Moral, and Physical Influences of 
the Mother Upon the Unborn — Transmission of Vital and 
Other Characteristics — The Highest and Holiest Duties of 
Earth Consigned to Woman — Discretion — Universality of 
Definite and "Well-regulated Laws — Pain, the Result of Hav- 
ing Broken Some Law — Unconscious Transgression — Like 
Begets Like, 

Co-existent with life itself — from the earliest pe- 
riod of human existence to the present, obedient to 
the Divine command, designed to subserve one of 
the grandest purposes of nature, essential to the 
preservation and continuance of our race — are the 
sexual attributes of man. 

Our first pareuts were created with the same 
physiological differences that characterize and dis- 
tinguish the sexes today, and though they were cre- 
ated in a state of maturity, there was engrafted upon 



18 PAINLESS CHILDBIRTH. 

their constitutions those self-same inherent proper- 
ties that actuate mankind in the present, having 
been transmitted from parent to offspring through 
the process of generation. 

What love is to the soul, the sexual attributes 
are to the physical part of man. Love is the rudi- 
mental element of the soul, the essence of the Al- 
mighty ; sexual attributes, the medium through 
which the spirit essence is transmitted to, and en- 
grafted upon, the physical being. Both are divine 
gifts, in perfect harmony with man's happiness, and 
conductive to his enjoyment. "Love constitutes 
the foundation of human nature ; " it is the motive 
power, as it were, of our impulses, actuating, regu- 
lating, refining human character. a Sexuality im- 
plies reproduction," and associated with love, is an 
instinct, the office of which is to repair the ravages 
of death by a continual transmission of life. The 
sexual passion is one of the most powerful impulses, 
and when subordinate to reason and love, its pur- 
pose "is rather to subserve the object of continuing 
the species than merely its own gratification." " Sen- 
suality is an unbridled desire which kills the soul. " 
" It degrades love and brutalizes man." 

Man is a rational being, endowed with rea- 
soning powers, capable of comprehending his at- 
tributes, and understanding the laws of their appli- 
cation. It is his duty to understand and observe 
whatever contributes to his happiness, and avoid 



SEXUAL ATTRIBUTES. 19 

whatever may cause suffering and misery. Igno- 
rance will not protect us from the penalties of bro- 
ken laws. 

It is by no means the author's wish to offend the 
fastidious, or pander to depraved tastes, yet the 
conviction is constantly forced upon him that if the 
public were better instructed upon sexual questions, 
far less suffering and crime would exist. "The 
proper study of mankind is man," and it is very 
appropriately said, " knowledge is safety." Reason, 
instead of instinct should govern our acts. The at- 
tributes capable of contributing to our enjoyment, 
as well as preserving our lives, are too often per- 
verted and abused, and thus become sources of pain 
and death. It is, therefore, proper that we under- 
stand these facts and live accordingly ; that we gov- 
ern oar passions instead of permitting them to govern us. 
This we cannot do if we do not understand the 
relations between cause and effect. 

If we are ignorant of the necessity of restraining 
our animal propensities, and of keeping them 
within proper bounds; if we do not know their 
boundaries, or if we are ignorant that we incur 
certain penalties if we over-step these boundaries, 
we will be constantly liable to violate both divine 
and natural laws, and be punished for the same, 
though at the same time not realize what we are 
being punished for. The majority of people blame 
Providence for their afflictions, while the truth is 



20 PAINLESS CHILDBIRTH. 

they have, though perhaps unwittingly, broken some 
law of their existence. It is not the author's intent 
to enter into the consideration of these laws and 
their effects in this work any farther than relates 
to the causes of pain in maternity, and how to avoid 
them, yet he hopes these hints will lead the reader 
to investigate the laws of life and the penalties im- 
posed for violating them. 

Neither sex is complete in itself, but the 

diversity attracts the one to the other — to complete 
the one by union with the other. Neither alone is 
capable of transmitting life, and their union is 
necessary, not only for the welfare of each other, 
but also for the purpose of carrying out the divine 
command, "multiply and replenish the earth." 
This attraction of the sexes " is the basis of mar- 
riage, and of the laws and customs which recognize 
the life-choice of one woman for one man." 

When love is pure and true, it does not find its complete sat- 
isfaction except in the indissoluble bond of marriage. Marriage 
is its natural consummation. 

Before sexual union it is the man that loves the most earn- 
estly, because he sacrifices more — pains, marches, contests ; he 
spares nothing. 

When the act is consummated, it is, in her turn, the woman 
who loves more, and for a longer time. Then her love becomes 
labor and suffering; she must nourish with her blood the being 
to which man has communicated life ; she must bring it into the 
world in the midst of cruel pains; she must continue for it in- 
cessant cares. — Bourgeios. 

Most observers concede that the sexual passion 
is stronger in men than in women ; indeed, some 



SEXUAL ATTRIBUTES. 21 

women have none at all ; and though- the absence 
of this passion is, in most cases, the result of disease 
or the early abuse of this function, there are cases 
met with in which sexual apathy is the only ab- 
normal condition present. In such cases philopro- 
genitiveness may be perfectly developed, and I have 
met many cases of the kind where women have 
become mothers without experiencing any sexual 
emotion whatever. 

There is another class in which a proper and 
natural degree of passion exists, while in still an- 
other, though smaller class, it exists in an unnatural 
degree, often amounting to nymphomania, a disease 
manifested by excessive erotic desires, which are 
controlled with great difficulty, if at all. Those of 
the first class, incapable of experiencing the emo- 
tions that influence and control the latter, regard 
them with contempt and hatred, when pity would 
be far more proper. Fortunately, such abnormal 
conditions are amenable to proper therapeutic 
measures. 

There should be neither passion, pleasure, nor 
pain which is not shared by both sexes. Generation 
is a duty ; " Children are a good and not an evil," 
and the feelings that impel to reproduction are as 
much a part of nature as is the hunger or thirst 
that prompts us to eat or drink. But it is a physi- 
ological fact that the moderate use of any function 
contributes to health, longevity, and enjoyment, 



22 PAINLESS CHILDBIRTH. 

while excessive indulgence is punished with physi- 
call ills.* 

Although it is possible for conception to occur 
where no sexual passion is manifested, nevertheless 
it is true " that the disposition of the woman at that 
time has much power in the formation of the foetus, 
both in modifying its physical constitution, and in 
determining the character and temperament of its 
mind." 

Her influence over the unborn does not, by any 
means, end with conception. For nine months she 
continues to impress upon it mental and physical 
characteristics that, to a very great extent, shape its 
future course and determine its usefulness in so- 
ciety. The moral influence of the mother must not 
be forgotten ; for it is while the rudimental brain 
and nervous system are being developed that im- 
pressions are easiest made and most apt to remain. 
Small influences at this time may grow into great 
variations of character in future. 

True, the impress of the father will be seen in the 
child, but it is during gestation that the foetus is a 
part of the mother herself — " blood of her blood, 
bone of her bone," and, we may add, nerve of her 
nerve. 

Circumstances that influence the life of the 
mother during this interesting period, necessarily 

*In this consideration, the author is desirous of being understood 
to mean reproduction, under such moral and social laws as govern 
the people where it takes place; it not being: his intention to discuss 
monogamy, bigamy, polygamy, or promiscuity in this work. 



SEXUAL ATTRIBUTES. 23 

exert a similar influence upon the child, in a 
greater or less degree. The stronger constitution 
of the mother may not be permanently impressed 
by external influences, while the child may be so 
affected that a life-time will not be long enough to 
efface them. Thus hereditary characteristics are 
transmitted and developed ; thus ante-natal influ- 
ences shape the destiny of the unborn. 

Excessive gratification of the sexual passions ex- 
husts the vital and nervous forces, deranges the 
vegetative functions, and lays the foundation of 
various diseases ; and the diseases and physical 
conditions of the parents at the time of conception 
and during gestation will materially modify the 
constitutions of their offspring. 

While the reproductive organs are not the seat of life, it is a 
well-established fact in physiology and pathology that they .ex- 
ert a most profound influence upon the performance of every 
function of the animal economy. Concerned as they are in the 
transmission of life, it is through them that vital and other char- 
acteristics are handed down to posterity, so that the welfare of 
the future generations depends materially upon their inheritance. 
Children born of parents suffering from diseases of these organs 
are generally defective in vital and other qualities, ill-tempered, 
sickly, and short-lived. — Baker. 

Children born of parents of fair intellectual quali- 
ties, but who have indulged their animal propensi- 
ties to such an extent that they are suffering vital 
defects, will usually be bright, keen of perception, 
have large heads, but will be physically weak, fall 
easy victims to diseases of various kinds, and in 
very many instances die under ten years of age. 



24 PAINLESS CHILDBIRTH. 

Sometimes the arts of the physician will avert those 
fatal tendencies of such constitutions, but were he 
able to do this far oftener than he is, how much 
better would it be to know the laws that regulate 
such conditions, and by living in obedience to them, 
avert the penalties of breaking them. Even though 
cures for diseases were always possible, how much 
better it would be to prevent them. 

Carry the question of vital transmission far- 
ther. Exhaust the vital qualities of the parents 
still more ; set up the diseases that follow the break- 
ing down of the system by excessive sexual indul- 
gences, and the children will rarely have the 
redeeming qualities of the former class, but will be 
scrofulous, idiotic, deformed, and epileptic. Scrof- 
ula ! What a multitude of sins that word covers ! 
Could those who use it know all that it implies, 
few would expose their sexual errors to the world 
by its utterance. 

Certainly, the highest and holiest duties of earth are con- 
signed to woman ; she is the one who moulds the physical form 
of her offspring and rears it to the stature of man, and shapes its 
moral and intellectual destiny. The embryotic being draws nu- 
triment and subsistence from its maternal parent, and derives its 
vital impress from the parent stock. Loveliness begets loveli- 
ness ; purity begets purity ; wisdom begets wisdom ; selfishness 
begets selfishness ; hatred, hatred ; bad temper, bad temper ; li- 
centiousness, licentiousness ; crime, crime., etc., etc. 

Excessive venereal indulgence, excessive child-bearing, ex- 
cessive nursing, are terribly destructive to the vital forces of 
woman's organization. * * * This slavish drudgery to ma- 
ternal requirements is the cause of many distressing disorders, 



SEXUAL ATTRIBUTES. 25 

producing irritability of temper, and all those domestic contre- 
temps which so often destroy the happiness of the family relation, 
and bring odium and disgrao upon the marital institution, de- 
signed by the ordinances of nature and heaven for the highest 
felicity of man and woman in a state of terrestrial existence. — 
Pancoast. 

The influence of moderation in these matters 
cannot be over-estimated. The evil influence of 
excesses are to be seen in both parent and child. 
As the excessive indulgences exhaust the vital 
forces, irritability is increased, the sensorium be- 
comes more and more acute, and trivial ills become 
severe pains or serious diseases, and the natural 
sensibility becomes so greatly exaggerated that the 
mother is subjected to continual agony both before 
and after birth. 

The act of generation is a voluntary one, but nature has so 
placed it under the empire of pleasure that the voice of discre- 
tion is no longer heard, and the will is led captive. Hence, it is 
well, for hygenic reasons, to consider its laws. 

Too frequent repetition of the reproductive act is known to 
be followed by consequences injurious to the general health. 
Too rigid continence is not unattended, in many constitutions, 
with danger, for the victory over passion may be dearly bought. 
Science recommends the adoption of a wise mean, between the 
two extremes equally destructive. By following her counsel, 
woman may escape from the hysterical and other disorders which 
often wait as well upon excesses, as upon the too great denial of 
that passion which claims satisfaction as a natural right— 
Napheys. 

The interests of man and woman are the 
same. Their object is to promote their own happi- 
ness, to prolong their own lives, and to perpetuate 
the race. The higher degree of perfection they at- 



26 PAINLESS CHILDBIRTH. 

tain, the greater their enjoyment, the greater their 
immunity from suffering. Pleasure should never 
be bought at the expense of pain. Each succeed- 
ing generation should be more perfect than its pre- 
decessor. Our race is susceptible of culture, but it 
cannot be trusted to chance. 

Certain definite and well-regulated laws 
are in existence throughout the universe. These 
rules must be understood and obeyed. Obedience 
will be rewarded and transgression punished. The 
providence of God asks nothing unreasonable of us, 
nor will it be likely to suspend any of its rules to 
favor an erring mortal. Ignorance will not be ac- 
cepted in extenuation of disobedience. The child 
that puts its tiny finger into the fire, ignorant of 
what the result will be, is as certainly burned as 
the older one who knows the consequences. The 
insane man leaps from a precipice and is dashed to 
pieces on the rocks below. He breaks the law of 
gravity, and pays the penalty with his life. The 
law of gravitation is not suspended because he is 
unaccountable for his act. So with all other natu- 
ral laws. 

Pain is the result of having broken some law. 
Had the law not been broken, the pain would not 
have been felt. These are facts. They look us 
squarely in the face. We may reason from cause 
to effect, from effect to cause, the result is the same. 
The question plainly presented to every individual 
is ; Is immunity from pain and suffering worth the 



SEXUAL ATTRIBUTES. 27 

little effort required to prevent them ? It is pur- 
posed in the following pages to consider some of the 
causes of pain, and teach prevention. As we im- 
prove our condition and knowledge, greater results 
may be anticipated, but we shall derive immediate 
benefit. Improvement is a forced state ; if we relax 
our efforts we shall be extremely liable to retro- 
grade. 

We have shown that it is a fixed law that th ca- 
pacities and dispositions of the parent are engarfted 
upon the offspring. Sick parents beget sickly chil- 
dren. Parents who keep their sexual functions in 
a state of excitement beget children that will be 
precocious in this direction. Consumptives beget 
consumptives. Venereal diseases descend through 
several generations, blighting the lives of many in 
the descent. Stock-raisers study the law of heredi- 
tary transmission, and is the human race of less 
consequence? All these considerations have a 
more or less direct bearing upon the pains and 
perils of child-bearing, and it is designed in the fol- 
lowing pages to specify these causes, explain their 
operations, point out both preventives and remedies, 
and render each woman capable of painless child- 
birth. 



28 PAINLESS CUILDBinTlt 



CHAPTER II. 



MATERNITY. 

Woman's Legitimate Object— The Highest and Holiest to which 
She Can Aspire— What Maternity Implies— Its Beginning 
and End— Early Development of Characteristic Traits— Ma- 
ternity Encouraged by the Ancients— All Women are Not 
Fit to Become Mothers— How the Transmission^ of Disease 
may be Favored or Opposed— Matrimonial Selections— 
Woman, Instead of Legislatures, Should Control Her Func- 
tions—How Our Civil Laws Operate— Abuses of Reproduc- 
tion—Opinions of Authors— The Confliction of Social and 
Natural Laws— Laws Against Preventing Conception— As 
Many Sterile Women Want Children as Fertile Ones Want 
to Prevent Them— A Mistake of the Newly-Married— The 
Proper Ao-e for Marriage, and its Influence on Mother and 
Child— Symptoms of Conception— Mothers' Marks— How 
Produced, How Prevented— Longings— Meddlesome Busy- 
bodies— The Plan of the Ancient Greeks— Who Should 
Nourish the Child. 

The office of maternity is peculiarly that of 
woman, and is the highest and holiest to which she 
can aspire. Its attainment requires many sacrifices 
which she is ever ready to make, and she considers 
herself amply repaid for the pains and perils she 
has to undergo when she clasps to her breast her 
new-born babe, the culmination of her anxiety, the 
central object of her affections, to her the crowning 
blessing of earth. 

Maternity is a legitimate object of woman's exist- 
ence, to be attained only through the exercise of a 



MATERNITY. 29 

certain function which, for the welfare of society, is 
not to be indulged outside of the marriage institu- 
tion. For this reason, if for no other, the parties to 
a marriage contract should study the law of adap- 
tation. Each party should possess good health, be 
free from any hereditary taint, and be by disposition 
prepared to reciprocate the love of each other. To 
love and be loved, to forgive and be forgiven, is 
essential to the happiness of both. 

Philoprogenitiveness, or love of offspring, is a 
faculty that " renders children the richest treasure 
of their parents, and casts into the shade all the toil 
and expense they cause, and lacerates them with 
bitter pangs when death or distance tears them 
asunder. It is much larger in woman than in 
man." The father may love his children earnestly, 
ardently, but it is different from the love of the 
mother. His affection may be turned away from 
them, but the love of the mother endureth to the 
end. 

The intensity of a mother's love is manifested in 
the sacrifices she makes to secure her child's happi- 
ness. Perhaps forsaken by the father of her babe, 
she struggles on alone in the world, careless alike 
ol frowns and hardships, only intent upon its wel- 
fare. Dying, her last prayer is for her child. 

She deprives herself of innumerable pleasures, 
foregoes the enjoyments of society, assumes the 
risks of unknown dangers, endures the pains of 
childbirth — many times suffering from the earliest 



30 PAINLESS CHILDBIRTH. 

period of gestation until long after delivery, to at- 
tain the joys of motherhood. 

Maternity begins with conception and ends only 
with the grave. Maternal instincts may exist in 
early life, and in the barren, but she must pass 
through the process of gestation, and undergo the 
ordeal of delivery — she must, in a word, become 
a mother — before she can fully realize what mater- 
nity means. 

The adaptability of the female to the require- 
ments of this important office is manifested very 
early in life — in childhood. While the boy plays 
with his ball, his horse and gun, manifests ambition, 
courage, power, exhibiting his aspirations to man- 
hood, the little girl plays with her doll, imitates 
the matron, and by word and act, indicates her 
wishes for a "real baby" long before she* can possi- 
bly realize, even in the slightest degree, the diffi- 
culties and dangers the gratification of her desires 
imply. 

Though it is through sexuality that maternity is 
to be attained, the maternal instinct is entirely dis- 
tinct from the sexual impulse, and the realization 
of maternity is often experienced without any 
knowledge whatever of sexual gratification on the 
part of the mother. 

Professor Laycock says : 

Maternity is the first and fundamental duty of the female ; thb 
male never, in a single instance, in any organism, contributes 
nutrient material. 



MATERNITY. 3i 

Madame Sirrey says : 

Those women who comprehend their rights and duties as 
mothers of families certainly cannot complain of their destiny. 

The office of maternity is respected the world 
over. In ancient Rome, the house of the newly- 
made mother was designated by the suspension of 
wreaths over the door to prevent intrusion, and as 
a mark of reverence. To encourage this holy office 
various countries have legislated in its favor, and 
pensions have been awarded to women who have 
borne many children. 

All women are not fitted for the duties 
and responsibilities of this holy office. There 
are a variety of circumstances that should be con- 
sidered in contemplating maternity. When one 
or both parents are suffering from diseases that in- 
fluence primarily their vitality, and are liable to be 
transmitted to their progeny, they have no right to 
bring beings into the world who must perpetuate 
the parents' misery by a life of continual suffering. 
Diseases or infirmities which threaten directly the 
physical or moral life of the individual are propa- 
gated, above all, by generation. 

The different forms of mania are liable to be ag- 
gravated by genital transmission. Epilepsy is 
liable to degenerate into cerebral maladies in the 
offspring. Consumption perpetuates itself in the 
race, and may become contagious for the other pa- 
rent. Uucured syphilis is transmitted through 
several generations. Scrofula, unless opposed by 



32 PAINLESS CHILDBIRTH. 

an excellent vital condition in one parent, will be 
intensified in the children. Improper tempera- 
mental alliances often develop disease among chil- 
dren where it had not been manifested in the 
parents. We should seek in marriage to neutralize 
by opposing constitutions, temperaments and pre- 
dispositions, the morbid hereditary elements which 
may be found in husband and wife. Marriage 
alliances should never be contracted between two 
persons who are essentially the same in tempera- 
ment ; who are lymphatic and scrofulous, nervous, 
phthisical, etc. We should seek to oppose the de- 
bility of one parent by a strong constitution in the 
other. When matrimonial contracts are formed, 
contrary to the above rules, the wife should sacri- 
fice her maternal desires for the welfare of the 
being she would otherwise bring into the world, 
lest she entail upon the prospective object of affec- 
tion a life of continuous misery. Among the lower 
animals, the most studious care is taken to breed 
only from the very best quality of stock ; quantity 
is sacrificed to quality ; and is the welfare of the 
human race of less importance ? 

We contend that no parents have a right to be- 
get more children than they can comfortably sup- 
port, and we appeal to the nobler sentiments of our 
fellow men in support of our position. We assert 
that it is the privilege of every woman to control 
her maternal function — to say when she shall have 
children, and how many. It docs not follow because 



MATERNITY. 33 

she is -married that she shall be robbed of her 
health and every enjoyment in life, in compliance 
to the sexual behests of her companion ; and no 
man of feeling, sense or decency will be willing to 
see the health, the beauty and the enjoyment of his 
wife sacrificed to excessive child-bearing. 

A host of writers — medical and non-medical — 
are arrayed against the subjection of woman to the 
infamous laws of modern civilization, which 
are too often upheld by religion. By the laws of 
our country, it is a criminal offense to procure, or 
aid in procuring, or to instruct any woman by what 
means she can regulate the number of her offspring 
by preventing conception. Under this law she 
must beget children, even though she knows they 
must suffer and die of some hereditary malady. 
Under this law she must beget children and bring 
them up in poverty, and subject them to starvation, 
vice and crime. But one alternative is left, and 
that is the criminal one of foeticide, or child-murder ! 
Indeed, this law demands that she sacrifice health, 
happiness, principle, and even life, in obedience to 
the demands of this most infamous enactment, in 
the passage of which she had not even a minority 
vote. 

Could the one single law of Providence govern- 
ing reproduction be suspended or reversed, and 
every man be compelled to have just one child, 
even though they might have the benefit of the 
following rules, the first act of our next Legislature 



34 PAINLESS CHILDBIRTH. 

would be the repeal of this obnoxious law, and every 
man ivould provide himself luith a preventive. 

The distinguished writer, John Stuart Mill, says : 

It is strange that intemperance in drink, or any other appetite , 
should be condemned so readily when incontinence in this respect 
should always meet, not only with indulgence but praise. Little 
improvement can be expected in morality until the producing 
too large families is regarded with the same feeling as drunken- 
ness or any other physical excess. 

The eminent Raciborski, in taking the position 
that avoidance of offspring to a certain extent is 
not only legitimate, but should be recommended 
as a measure of good, says : 

We know how bitterly we shall be attacked for promulgating 
this doctrine, but if our ideas only render to society the services 
we expect of them, we shall have effaced from the list of crimes 
the one most atrocious, without exception, that of child-murder — 
before or after birth — and we shall have poured a little happi- 
ness into the bosoms of despairing families, where poverty is 
allied to the knowledge that offspring can be born only to pros- 
titution and mendacity. The realization of such hopes will con- 
sole us under the attacks upon our doctrines. 

Dr. Edward Reich says : 

After reviewing the multitudinous evils which result to indi- 
viduals and society from the too rapid increase of families, it is 
much to be wished that the functions of reproduction be placed 
under the dominion of the will. 

Dr. Napheys remarks : 

. Men are very ready to find an excuse for self-indulgence, and 
if they cannot get one anywhere else, they seek it in religion. 
They tell woman it is her duty to bear all the children she can. 

In bis work on Fecundity, Fertility and Sterility, 



MATERNITY. 35 

Dr. Duncan, in considering the subject of the size 
of families, says : 

Neither the arguments of Malthus, nor any others, apparently 
justify us in calling on a healthy couple to limit the number of 
their children, when they will receive a fair education and such 
an outfit as will enable them to produce so much wealth by their 
labors as will probably insure them against want. It may well 
be doubted, whether for the sake of self-indulgence, and with a 
little more wealth, such a couple would be justified in placing a 
limit to the number of their children. But think of another and 
too frequent case. Think of a man and woman struggling with 
poverty, absolute or relative, with more children already than 
they know how to educate, to clothe, even to feed ! Think of 
the woman bowed with ill health, peevish from petty trials! 
Think of the children, each on its arrival regarded as a misfort- 
une, if not a curse, growing up unhealthy, ill-cared for, dirty, 
ignorant, with no better prospect than to repeat the life of its 
wretched parents ? Would these parents do wrong in refusing 
to be instrumental in multiplying a race of paupers ? Between 
these two extremes may not each man and woman ask themselves 
the question, whether any duty obliges them to procreate children 
whose advent they will deplore ? 

Some may be shocked even at the question, regarding the 
births of children as the special intervention of Providence. We 
shall not quarrel with these persons, remembering wdiat are the 
faculties and possible destiny of each child born ; but we cannot 
refuse to see that Providence will not send children without 
some action on our part. There is no obligation binding on men 
and women to begin the begetting of children. Having begun, 
must they go on perforce ? The argument as to interfering with 
Providence is quite disregarded now as to epidemics, and it is a 
little difficult to see the distinction between interfering to pre- 
vent excessive deaths and excessive births. Indeed, if we dis- 
turb the old balance by preventing a high death-rate, it seems 
almost incumbent on us to restore the equilibrium by diminish- 
ing the birth-rate. It seems a strange docrrine that we, with 
our privilege of free-will, with reason, with religion for our 
guides, shall be debarred all choice in this matter, and be reduced 
to a level with brute beasts, each species of which is limited by 



36 PAINLESS CHILDBIRTH, 

death and suffering alone. We wholly disagree with those Who 
indulge their senses- and expect Providence to protect them from 
the consequences of their incontenence. 

I am convinced from careful study and extensive 
research that society or population would not suf- 
fer if the act of generation was wholly under the 
dominion of the will, for there are as many sterile 
women who desire children as there are fertile ones 
who wish to avoid them. The force of this obser- 
vation is more apparent when we assert that in 
about ninety-five per cent, of cases of sterility, the 
barrenness is caused by diseases, and may be cor- 
rected. 

The intelligent and impartial consideration of 
the subject is necessary, and should be taught rudi- 
men tally in our schools, even though it were ad- 
visable to establish special schools for the purpose. 
The law against preventing conception does not 
regulate the number of illegitimate children, nor 
diminish prostitution ; for if the fear of conception 
is the only barrier the law opposes to the unlawful 
indulgence of the sexual propensities, it is too fee- 
ble to merit a moment's thought. The immoral 
care nothing for it, while on the other hand, wives 
who cannot resist or evade the responsibilities, are 
often compelled to beget offspring under circum- 
stances of the most lamentable and cruel kind. 

Had woman the possession of herself, and the control of her 
maternal functions and duties, instead of grevious sufferings and 
privations, she would have health and beauty ; not only of her 
own organization, but she would become the mother of children 



MATERNITY. 37 

equally vigorous and lovely. Surely, nothing is more wicked 
than to bring into the world such numbers of helpless and inno- 
cent beings to doom them to poverty, ignorance and crime, 
because of their parents' inability to make necessary provision 
for them. — Pancoast f 

I have no wish nor intent to break any law, nor 
encourage others to do so, no matter how unjust it 
may be, but for the sake of the oppressed I seriously 
hope the attention of legislators will be given to 
the matter, and that it may receive proper scientific 
investigation. 

Hhe influence of the mother over the career 
of her child is immense, and it should be rightly 
directed. A noted divine has well said, u to be good 
mothers of men and women is the greatest thing in 
all this world ; " and we will add, the better the 
mothers the better the children in every respect, for 

" The hand that rocks the cradle is the hand that rocks the 
world." 

Physical conditions may be cultivated, but the 
germs must first exist. It is difficult to give other 
than what we have, or transmit what we no not 
possess. 

It is a mistaken notion among many newly- 
married people that they do not want children. 
Many who have thought thus have had occasion to 
regret their folly, when later in life the wife finds 
herself permanently sterile, or suffering from dis- 
ease which the unphilosophical and unphysiologi- 
cal methods of preventing conception she has 
practiced, entail. 



38 PAINLESS CHILDBIRTH. 

The age of the wife lias an important bearing 
upon not only her health, her fertility and severity 
of labor, but upon the constitution of her offspring. 
Every man and woman should possess a plenitude 
of life before they communicate it to another. The 
body should have attained its growth for at least a 
year,, and every function be fully and perfectly 
established. After puberty, the pelvis of the female 
undergoes important anatomical changes to fit her 
for child-bearing. These changes require time (sev- 
eral years), and it is not until they are completed 
that she is fully qualified to perform her part in 
the process of reproduction. 

Comparison of the skeletons of males and females 
after puberty shows a marked difference in their 
relative breadth and depth, that of the woman be- 
ing greatest, for two reasons, viz. : The accommo- 
dation of certain organs which are peculiar to her 
.alone, and the easy expulsion of the foetus when 
conception is completed. The age at which this 
pelvic difference matures varies from twenty to 
twenty-five, and conjugal unions should not, on an 
average, be formed prior to the earliest period indi- 
cated. Between twenty-five and thirty is the period 
of the greatest fertility, and first confinements 
between these ages are least difficult and dangerous. 

Aristotle observed : 

To the female sex, premature wedlock is particularly danger- 
ous, since, in consequence of anticipating the demands of nature, 
many of them suffer greatly in childbirth, and are liable to pro- 
duce imperfect offspring. 



MATERNITY. 39 

His observations are fully confirmed by writers of 
the present day. The children of such marriages 
are sickly, puny, and defective in mind and body. 
They inherit more readily the defects of their an- 
cestors, and as a rule, die at earlier years than the 
progeny of better-timed unions. 

Dr. Naphey says : 

A too youthful wife finds marriage not a pleasure, but a pain. 
Her nervous system is prostrated by it ; she is more liable to 
weaknesses and diseases of the womb ; and if of a consumptive 
family, she runs great risk of finding that fatal malady mani- 
fested after a year or two of married life. It is very common 
for those who marry young to die young. 

Admitting that there are many exceptions to this 
rule, it is no argument in favor of early mar- 
riages, because there is nothing to be gained except 
in rare instances. It has been argued in favor of 
early marriages that uterine diseases in young girls 
are sometimes cured by it. The risk is too great, 
for in every case where one has been benefitted, 
hundreds have been made worse. My own obser- 
vations of the results of early marriages conform 
to the foregoing. Many mothers have suffered 
from uterine and nervous diseases, while their chil- 
dren have possessed puny constitutions. 

On the other hand, marriages late in life are 
equally objectionable. Barrenness is more frequent 
after thirty, while the first labors after that age are 
apt to be more protracted and dangerous. The 
farther this period has passed the more rare first 
births become, and at forty-six the child-bearing 



40 PAINLESS CHILDBIRTH. 

period of woman ceases entirely, though some 
notable exceptions have been known. 

The occurrence of pregnancy occasions pe- 
culiar changes in the mental and physical con- 
dition of the prospective mother. The menstrual 
function is suspended, and a profound impression 
is made upon the nervous system. Changes in the 
breasts occur. The appetite is often changed and 
becomes peculiar, or even depraved. There may 
be unnatural longings for certain articles ot food, 
salivation, heart-burn, palpitation, pains in various 
parts of the body, etc. Mental peculiarities develop ; 
the pleasant, confiding, gentle, gay, loving woman 
becomes hasty, passionate, jealous and bitter. Some- 
times those who are naturally bad-tempered become 
much more pleasant. During the first two months 
the abdomen is less prominent than natural, and 
may even continue so until after quickening, but 
after this time it steadily increases until delivery. 

One of the most annoying symptoms of gestation 
is morning sickness. In some instances it be- 
comes so severe as to seriously endanger life. It 
has been an old axiom that a sick pregnancy is 
always a safe one, and that the absence of nausea 
and vomiting foreboded danger to the mother or 
child. For my own part, I cannot understand why 
a condition so extremely unpleasant is a healthful 
one, nor can I understand why a condition of the 
stomach that is pathological to a non-pregnant 
woman, should be physiological to a pregnant one. 



MATERNITY. 41 

My own observation does not coincide with the 
time-honored proverb, and I prefer to believe that 
nausea and vomiting depend upon conditions that 
it is not only desirable, but proper to relieve. In 
a large per cent, of cases that are so severe as to 
require professional attention, it is evident that in 
the early stages the irritability of the stomach is 
propagated to the p f omach through the sympathetic 
nervous system, from the uterus and its appendages. 
Anything that lenders the nervous system weak 
and irritable is capable of producing this condition. 
Experience has proved that remedies addressed to 
the stomach for the vomiting of pregnant women 
are generally futile, while remedies addressed to 
the nervous system succeed. The application of a 
small quantity of chloroform over the pit of \he m 
stomach lessens, or for a time suspends, the irrita- 
bility of the gastric nerves and controls the vomit- 
ing. The injection of a strong solution of bromide 
of potassium into the rectum allays the irritability 
at its source, and relieves its remote influence. The 
dose for the purpose should not be less than a dram 
in an ounce of warm water. Where the sympathetic 
vomiting has set up an actual inflammation of the 
stomach, then it will be necessary to address reme- 
dies to the stomach as well as to the nervous system. 
We have already referred to the influence of the 
mother upon the health and character of the child, 
and it will not be out of place if we here briefly 



42 PAINLESS CHILDBIRTH. 

consider the subject of mothers' marks and beauti- 
ful children. 

Although there is a great diversity of opinion 
about how mothers' marks are produced, yet the 
very fact that they do exist is evidence that there 
must be some cause. • We will, no doubt, always be 
confronted with instances in which these marks 
cannot be traced to any assignable cause ; and, on 
the other hand, "assignable causes" will have 
proved inoperative. The profession has very gen- 
erally conceded that the mind is capable of pro- 
ducing certain diseases in various organs, and that 
it has been instrumental in curing such diseases 
when they have existed. Admitting this fact, to- 
gether with the hereditary transmissibility of dis- 
ease, we can understand how these marks are 
produced. 

Some writers have urged that there is no nervous 
communication between the mother and child. 
While we will not debate this point, we are certain 
there is a direct communication through the blood, 
which is sufficient, were we to leave "sympathy" 
entirely out of the question, and if one quality may 
be transmitted through this medium, why may not 
others ? 

No one will attempt to deny that during preg- 
nancy the mother is unusually susceptible to ex- 
ternal impressions ; and in view of the accumulated 
evidence, we regard it safe to state that any external 
circumstance that is capable of making a profound 



MATERNITY. 43 

or prolonged impression on the mother, may, 
through the blood or sympathy, affect the child in 
utero. 

We might bring forward numerous instances to 
substantiate our views, but we regard them as en- 
tirely unnecessary. Every neighborhood has its 
examples. The prospective being is really a part 
of the mother herself, and will be subject, to a very 
great extent at least, to the same influences. 

A practical conclusion suggested by this 
consideration, is to remove the prospective mother 
as far as possible from the operation of those influ- 
ences that may make unfavorable impressions upon 
the fragile structure of the unborn, and surround 
her with such influences as create a healthful, 
cheerful and agreeable state of the mind. This 
should be remembered by husband, attendants, as- 
sociates, and all who are brought in contact with 
her. The mind should be agreeably occupied — 
refinement, pure emotions, noble sentiments, equa- 
nimity should be cultivated, together with every- 
thing that contributes to good nature, enjoyment 
and serenity. 

Avoid the presence of unsightly and disagree- 
able objects, and as quickly and quietly as possible 
divert the mind from them. Gratify unnatural 
" longings " as far as is consistent with reason and 
circumstances, and thus terminate their influence. 
Do not worry yourself about something you can 
not help, nor anticipate trouble that may never 



44 PAINLESS CUILDBIRTH. 

come to pass. Cultivate control over the will. 
Dismiss unpleasant thoughts and unreasonable fan- 
cies as quickly as possible ; think of something 
else ; do not listen to the horrible and terrifying 
stories which neighboring gossips delight to tell, 
nor be kept in a state of terror and anxiety about 
the termination of the conception, by the yarns of 
those meddlesome old grannies who are always 
acquainted with some case that was just like yours, 
and something happened. 

Every community is unfortunately cursed by 
such busy-bodies. Heed them not ; they are no 
more capable of judging of your condition, or pre- 
dicting the future, than they are to be President, 
and their tales are nearly always imaginary. 

Contemplate grace and beauty, and by such a 
course you will be not only likely to avoid mothers' 
marks, but beget healthful, talented, beautiful chil- 
dren. Cultivation of mental qualities is worthy an 
effort. If it is desired that the unborn excel in 
some branch of learning or profession, let the 
mother exercise her mind in that direction. In a 
word, keep the mind free from unpleasant subjects, 
unhappiness, anxiety, anger, etc., but filled with 
agreeable fancies and charming images ; cultivate 
graceful attitudes ; remembering that her course 
now must be reflected in the future character of her 
unborn babe. The ancient Greeks surrounded 
pregnant women with statuary, paintings and en- 
gravings, and with good results. 



MATERNITY. 45 

It is well known that artificial feeding is one of 
the fruitful causes of infant mortality, consequently 
when no physical condition exists to prevent it, 
every mother should nurse her own child. With 
birth the cares of maternity are increased, and the 
obligation is imposed upon the mother of nourish- 
ing the little being she has brought into the world. 
Science has pointed out that it contributes to her 
physical welfare, and is to most mothers one of the 
pleasures of maternity. 

I do not, however, wish to be understood as ad- 
vising all women to nurse their children. Many 
women cannot supply milk of the proper quality, 
and while they might be benefitted by nursing, 
under such circumstances it would be extremely 
detrimental, if not absolutely destructive, to the 
child. 



46 PAINLESS CHILDBIRTH. 



CHAPTER III. 



IS PAIN NECESSARY ? 

The Answer to this Important Question — Has the Almighty a 
Special Design in Afflicting Woman — If the Descendants of 
Adam Escape Pain, why not the Descendants of Eve — Spe- 
cial Providences — Efficacy of Prayer — The Performance of 
Healthy Functions Painless — Childbirth is Natural, and 
Should be Painless — Pain a Sign of Disease — All Women 
do not Suffer — Uncivilized Usually Escape — Why — Instan- 
ces — Obstetrical Literature Nearly Silent — Pain is Unnatural 
and Unnecessary. 

To the child-bearing woman, few questions are 
of greater import, and it is to be hoped the writer 
will be able to convince his readers that the ques- 
tion may be truthfully answered in the negative. 

When we observe the little suffering the lower 
animals experience in bringing forth their young, 
we are at once led to inquire : Is it necessary that 
the human female, created in the image of God, 
should suffer as she does in childbirth ? Why is 
she specially selected to endure such agony ? Can 
the Almighty have any special design in afflicting 
her thus ? 

Thysiologists tell us that the healthy perform- 
ance of any function is unattended with pain ; that 
natural processes are painless, and that pain 



IS PAIN NECESSARY f 47 

is the result of a morbid condition. It is conceded 
that child-bearing, being necessary to the perpetu- 
ation of our species, is the natural function of 
woman ; consequently, if we accept the doctrines 
(if physiology, we can only infer that childbirth 
should be without peril, and without pain. 

We cannot believe that the Almighty ever in- 
tended woman should suffer such terrible misery, 
while her male companion, equally interested in 
its results, should wholly escape. If such be the 
design and it is necessary, then w r hy do some suffer 
so much more than others ? If the descendants of 
Adam are enabled by any means to practically 
escape the curse pronounced in the garden, why 
not the descendants of Eve ? 

This may seem sacriligious to those who are ever 
ready to blame Providence for their mishaps ; but 
while we respect the opinions of all, we cannot help 
noticing that those who are the most ready to at- 
tribute to the dispensation of Providence all 
their ills, are generally very prompt in seeking 
human interposition to mitiga^te the suffering oc- 
casioned by such special dispensation. A genuine 
attack of colic or cholera morbus will take the spe- 
cial dispensation doctrine out of a man in very 
short order ; and though he may pray for another 
special dispensation to relieve him, he is generally 
anxious that a speedy messenger be dispatched for 
a doctor about the same time ; and what is colic or 
cholera morbus, in comparison with the pains of 



48 PAINLESS CHILDBIRTH. 

childbirth ? Let those who have experienced both 
answer. If it is right to relieve the pains of one 
by human efforts, is it not right to relieve or pre- 
vent the agony of the other ? 

The truth is, Providence is no more to blame for 
the suffering of one individual than of another, 
and will not suspend or reverse any law to accom- 
modate anybody. We are born subject to certain 
organic laws, and if through willfulness or ignor- 
ance we violate them, we must suffer the conse- 
quences. Providence is no more to blame for 
disease and pain than for picking of pockets, or 
stealing horses. We have charge of our constitu- 
tions, and if we will not learn how to care for them 
— learn how to prevent disease and pain — we must 
suffer, and no interposition of the Almighty need 
be expected, nor will the plea of ignorance be ac- 
cepted in extenuation. 

For our part, we cannot believe the Almighty 
the cruel, merciless tyrant many picture Him, but 
believe in His wisdom, mercy and justice. He has 
placed at our disposal abundant means for our 
relief if we will but comprehend and apply them. 

It is not our purpose, however, to discuss the pain 
question upon its theological merits, still if there is 
the efficacy in prayer that has been accorded to it ; 
the pains of childbirth are a consequence of the 
curse uttered in Genesis 3 : 16-17 ; and if the pur- 
poses of the Almighty are ever changed, it would 
seem that there have already been prayers enough 



IS PAIN NECESSARY f 49 

offered for woman's deliverance to have effected it, 
for certainly she has suffered enough to satisfy the 
devil, much less a God. 

Perhaps some enthusiastic Malthusian will set up 
the claim that the pains and perils of childbirth 
are necessary to constitute a check upon over- 
population. If that is the case, it would appear 
that after being tested six thousand years and 
proving a failure, it is about time the plan was 
abandoned and some other one tried. 

It is very evident that all women do not experi- 
ence the same degree of suffering, and we infer 
there must be some good reasen for the difference. 
Every effect must have a cause, and the question 
arises : Are we not capable of ascertaining the 
reason why some suffer less than others, and, by 
applying the same conditions to all, ameliorate the 
suffering of all ? 

Travelers tell us that the females of uncivilized 
nations suffer less in childbirth than those of civil- 
ized, and we cannot entertain the idea that the 
heathan mother is more a favorite in sight of 
heaven than her Christian sister. Hence, some 
other explanation is necessary, and we come to 
believe that the difficult, painful and tedious labors 
are due to some physical condition of civilized 
woman, which the uncivilized escape. 

The uterus is a hollow, muscular organ 
that gradually enlarges as gestation goes forward, 
until the termination of pregnancy, when, for cer- 



50 PAINLESS CHILDBIRTH* 

tain reasons unnecessary to consider in this con- 
nection, it contracts, and after repeated efforts, 
expels its contents amidst intense suffering. 

The heart is a hollow, musclar organ that, 
by its alternate expansion, or dilation and contrac- 
tion, receives the blood from the veins and sends it 
coursing again through the arteries to every part 
of the body. Its contractions are forcible, and 
represent an amount of muscular power immensely 
greater than the uterus. 

The stomach is also a hollow, muscular 
organ that, by its contractions and motions, churns, 
mixes and comminutes its contents until prepared 
for expulsion. 

The bladder is another hollow, muscular 
organ that dilates slowly as the urine accumulates 
within its cavity, until a certain degree of disten- 
tion is reached, when it contracts and the urine is 
expelled. 

All of these organs are supplied with nerves of 
sensation, yet they perform their natural functions 
without pain. 

The general structure of the uterus is similar to 
the other organs mentioned, and expels its contents 
by contractions, in a manner similar to the others ; 
then why should its operations be attended with 
pain and the others escape ? This reason is 
plain. The heart, stomach and bladder are in a 
healthy condition, and in that condition not sen- 
sitive to pain. Let them become affected by disease 



IS PAIN NECESSARY f 51 

and every contraction they make is performed in 
agony. 

In dyspepsia, the stomach becomes diseased, and 
the dyspeptic knows what it is to suffer ; yet he 
does not believe his pain is necessary, and quietly 
submit to it without an effort to effect a cure. 

Inflammation and other diseases of the heart 
create intense suffering, and disturb every function 
of the body. 

When irritation or inflammation of the bladder 
occur, every contraction is attended with the most 
excruciating agony. 

Thus it must be apparent that when these or- 
gans are in a healthy condition, their func- 
tions are painless, and are performed in an 
almost unconscious manner ; but when a patholog- 
ical state is developed, agony is the result. 

From this we rationally infer that the reason the 
contractions of the womb are attended with pain 
is because some morbid condition of it, or adjacent 
structures, exists. 

All accouchers have remarked that cases are 
often met where the contractions of the womb are 
prolonged and vigorous, and yet the woman will 
complain very little. From this we are led to 
infer that the anatomical construction of the parts 
is favorable to the process, and that the uterus and 
its attachments have not been rendered sensitive 
by morbid conditions. A healthy uterus is not 
sensitive, and parturition should be painless. 



52 PAINLESS CHILDBIRTH. 

The eminent obstetrican, Dr. Dewes, argues : 

Pain in childbirth is a morbid symptom; that it is a perversion 
of nature, caused by modes of living, not consistent with the 
most healthy condition of the system ; and that such a regimen 
as should insure such a completely healthy condition might be 
counted on with certainty to do away with such pain. 

Prof. Huxley says : 

"We are, indeed, fully prepared to believe that the bearing of 
children may, and ought to become, as free from danger and 
disability to the civilized woman as to the savage. 

Pancoast, in his Ladies' Medical Guide, says : 

It is a common belief that gestation is a period of disease and 
suffering, and that parturition is inevitably a painful and danger- 
ous process. Now the great truth yet to be learned is the reverse 
of such impressions. It is just as natural for a woman to bring 
forth children as for a shrub to produce flowers and fruit. In a 
state of health, no natural process is painful. Pain, in all cases, 
is a sign of disease — it has no other significance. In its healthy 
condition, the uterus receives the germ of a new being, provides 
it with proper nourishment, expands to make room for its de- 
velopment, and, at the time appointed by nature, dilates its 
opening and contracts — a series of involuntary and painless 
muscular efforts — so as to throw the infant into the neiw exist- 
ence, which its growth demands. It performs its own proper 
functions, just as the lungs, the heart, or the stomach perform 
theirs, because it was.formed by the same Infinite Wisdom and 
Goodness who ordained that pain and sorrow should be the con- 
sequence of sin, and who ordains that health and happiness shall 
ever be the result of obedience to the laws of life. 

It is well known that the slave women of this 
country required very little or no attention at con- 
finement. 

Their labors are generally of short duration, the 
pain moderate, and the woman is incapacitated 



IS PAIN NECESSARY? 53 

from performing her usual avocations only a few 
hours. 

Among the poorer classes, i e. } those who 
are robust, but compelled to depend upon their 
daily toil for the necessities of life — the plainest 
food — to whom luxury is a stranger, we often find 
the labor easy and speedy, and often with no attend- 
ant, except, perhaps, the husband or a little girl — 
not even a midwife. The woman gives birth, and 
in a few hours resumes her usual duties. 

It is generally known among the American In- 
dians that the avocations of the squaws are 
seldom, if ever, interrupted by an inconvenience 
from pregnancy or labor, except for a very short 
period at the time of birth. My brother-in-law, 
Dr. S. T. Baker, who has spent many years on the 
western frontier among the Indians, where he had 
excellent opportunities to observe and acquaint 
himself with their habits, assures me that a preg- 
nant squaw does not occasion any concern from her 
companions. She performs the usual drudgery of 
her life up to the very hour of her labor, making 
no preparation for the coming " pappoose." When 
she realizes that the hour for delivery is at hand, 
she enters her cabin or betakes herself to some 
stream or spring, gives birth, washes the young 
"Injun" in the cold water, straps it upon her back, 
and before she has been scarcely missed, has re- 
turned a full-fledged mother, and resumes her 
labors unconscious of having undergone any very 



54 PAINLESS CUILDBIMTB. 

wonderful ordeal. If the band to which she be- 
longs is on a march when she feels that labor is 
upon her, she leaves the trail, and beside some 
brook or spring spreads her blanket, is delivered, 
washes the infant, straps it upon her back, mounts 
her pony, gallops on after the rest, whom she over- 
takes after one or two hours' absence. If they 
experience any of the annoyances of pregnancy 
that afflict the daughters of artificial life, they pay 
so little attention to them as to attract no notice 
whatever. 

Caseaux remarks : 

There are certain females who have the happy privilege of 
being delivered without any, or, at least, very inconsiderable 
pain. I had the opportunity at the clinique of observing a 
. young woman in her first labor, who was aroused by the pains 
at four o'clock in the morning and was delivered at six. During 
these two hours she suffered so little that she did not consider it 
necessary to alarm a-ny one, until the pains became a little more 
severe, when the midwife was summoned and found the head 
had been delivered. 

Nearly all physicians can recall cases in their 
experience when, having been hastily summoned, 
they have found, on their arrival a few minutes 
later, that delivery was completed, and that they 
had been summoned as soon as the woman herself 
realized that the labor had begun. 

In an English work on midwifery, we find the 
following statements : 

That a respectable lady, the wife of a peer, was actually de- 
livered once in her sleep. In another instance, a woman bore 
eight children without ever having labor pains, and her deliv- 



IS PAIN NEC ESS ART f 55 

eries were so sudden and devoid of sensible effort that, in more 
than one instance, they took place under very awkward circum- 
stances. 

While practicing medicine in the eastern part of 
this state (New York), several years ago, I was 
called several miles into the country to attend a 
case of obstetrics. On my arrival, the husband 
informed me that his wife was not much sick, and 
that he guessed that it was a false alarm. As it 
was storming violently, and was near the dinner 
hour, I concluded to have my horse cared for and 
get dinner myself before my return, whether it was 
necessary to stay longer or not. On entering the 
house I found the wife assisting in getting dinner, 
which was nearly ready. She remarked she was 
sorry to have called me out in such a storm for 
nothing, Dinner over, she resumed her household 
duties, but suddenly sitting down in a chair re- 
marked that it was not a " false alarm " after all. 
We assisted her upon a bed as quickly as possible, 
and in less than five minutes from the time she 
called her husband the child-w T as born. The after- 
birth was soon delivered, and a good recovery 
followed. She assured me she had not experienced 
any pain. 

Such cases could be indefinitely multiplied, did 
space permit, or if it was necessary ; but admitting 
them to be exceptional cases, they prove the possibility 
of painless childbirth. 



56 PAINLESS CIIILDBinTn. 

We know there are many authors who regard 
pain as essential to childbirth, and think woman 
must ever suffer as she does now ; and we have 
been not a little surprised in examining obstetri- 
cal literature to find how little attention has been 
paid to considering the causes of pain, or to any 
effort toward prevention. The idea of making 
childbirth easy seems to have been wholly over- 
looked in the endeavors to develop means to 
relieve difficult labors. Evidently they have re- 
garded this grand function of the uterine system a 
pathological instead of physiological process. 

The duration of labor is a subject upon 
which considerable difference of opinion prevails. 
On account of the change the abdomen and its 
contents undergo at the time, the delivery should 
not be so quick, but that the contractions of the 
abdominal muscles may have time to adapt them- 
selves to the change, and from one to three hours 
is not too long. This, however, is a much shorter 
time than is usually occupied, and labor is said to 
be " natural " when it lasts from six to thirty-six 
hours, and the woman kept in bed two or three 
weeks. The dangers to be apprehended from too 
rapid delivery are rupture of the perineum, 
flooding or syncope. 

From the foregoing, it must be evident to the 
unprejudiced mind that childbirth is a natural 
process, when the mother lives in accordance with 
the laws of health. 



IS PAIN NECESSARY ? 57 

Natural labor is an easy, short and painless act. 

Natural labor is never painful. 

The organic nerves that supply the uterus are 
never sensitive in a healthy state. 

Irritation, debility, congestion and inflammation 
render these nerves sensitive and painful. , 

All pain, difficulty and danger are the conse- 
quences of violating natural laws. 

Banish disease, enforce hygiene, establish health, 
and labor will not be difficult. 

All of these assertions will be proven as we pro- 
ceed, and full directions for relieving the pain, or 
of preventing it, will be given, that will convince 
those who try it that pain in childbirth is un- 
necessary. 







^ 
^ 



58 PAINLESS CHILDBIRTH. 



CHAPTER IV. 



CAUSES OF PAIN. 

Unhygienic Customs — Physical Condition — Social Influences — 
Slavery of Different Stations of Life Contrasted — Irritable 
Nerves — Curvature of Spine — Malformations — Tight Lacing 
— Shape of Pelvis — Female Diseases — Improper Treatment 
Errors — Marital Relations — How the Condition of the Child 
Affects the Mother — Its Size — Hardness of the Bones — All 
these Causes can be Rendered Inoperative. 

The causes of pain at childbirth are various, 
and may depend upon the condition of the mother, 
or upon the condition of the child. These causes 
may be either remote or proximate, direct or indi- 
rect. In some cases the causes will have ceased 
long ago, but their effects will remain. 

Unhygienic customs beget morbid conditions, 
and thus render natural processes painful. Any 
cause that can retard or oppose delivery, and pro- 
tract labor, increases the suffering of the mother, 
and if continued beyond a certain point, endangers 
the life of both mother and child. 

Childbirth to be proper and painless requires 
that the shape of the mother be perfect ; every 
organ must be developed, and the pelvic bones be 
anatomically correct in shape. No deformity is 
admissible. The distance from the junction of the 



CAUSES OF PAIN. 59 

pubic bones to the sacrum must be sufficient to per- 
mit the passage of the child without too great a 
degree of pressure. There must not be any un- 
natural obstructions. The abdominal, pelvic and 
uterine muscles must possess sufficient power that 
they may complete the process without undue de- 
lay, when expulsive efforts begin. The nervous 
system must be quiet, and the mind must be at 
ease. Every tissue must be healthy ; no morbid 
conditions present. Then the child must not be 
deformed, too large, nor its bones too much ossified. 
Secure these conditions and labor will be materially 
shortened in duration, and the suffering reduced to 
a minimum. 

Modern social customs impose upon woman arti- 
ficial modes of life that impair her constitutional 
vigor, deform her body, pervert her functions, 
render her an easy prey to uterine diseases and to 
prolonged and painful childbirth. These customs 
are indirect or remote causes of pain, because they 
create conditions of life which, in their turn, ren- 
der pain unavoidable. The uncivilized mother, 
uninfluenced by fashion, with the abdominal and 
pelvic muscles w T ell developed by the exercises to 
which her life subjects her, her hips broad and 
deep to support the burdens she must often carry, 
her nervous system not rendered acutely sensitive 
by debility or disease, almost entirely escapes the 
pains and perils of childbirth to which the society 
woman falls a victim. 



60 PAINLESS CHILDBIRTH. 

Bring the matter nearer home, and let us com- 
pare the slavery of the two classes — the one woman 
a slave to fashion and society, the other a slave to 
physical necessity. The first, malformed by dress, 
the muscles undeveloped, and the sensory nerves 
made intensely sensitive by disease and her manner 
of life, suffers long and severely at such times, 
while the other, well formed by nature, developed 
by the exercises her position in life necessitates, 
with no irritable or inflamed nerves to annoy her, 
pays no attention to it further than the inconven- 
ience occasioned by a few days' absence from work, 
and the additional tax upon her resources for the 
maintenance of her child. Again, during preg- 
nancy and probably for some weeks after delivery, 
the suffering of the fashionable woman has been 
continuous, while the other has scarcely noticed 
her condition. 

There is a noticeable difference in the degree of 
the anterior curvature of the spinal column at its 
lumbar portion, between the lower ribs and the 
hips, in the two classes of women — the society 
lady's back bending inward or forward considerably 
the most, so that the power of the vertebral pile to 
support weight from above downward with ease, is 
diminished on account of the greater angle, giving 
rise to tbe sensation of " backache, as if it would 
break in two." 

This is one of the results of tight-lacing and 
insufficient physical culture, and to any one who 



CAUSES OF PAIN. 61 

will consider physical laws, its influence in produc- 
ing female diseases, in prolonging labor and in- 
creasing its pain, must be obvious. This increased 
curvature throws the abdomen forward beyond the 
direct line of the body, and in childbirth much of 
the abdominal muscular effort, particularly of the 
diaphragm, is lost, because it is expended in the 
direction of a line with the pubic bones instead of 
the cavity behind them, the pubic bones opposing 
a force that no muscular effort can overcome, even 
were such a result desirable. In such cases the 
labor is protracted on account of the improper 
direction of the muscular force, which is often 
feeble on account of the customary inactivity of 
the muscles preventing their natural development. 

The woman who, in her daily labors, is compelled 
to perform such exercises as develop all her muscles, 
particularly the erector muscles of the spine, to 
support the heavy weight she is often obliged to 
carry, by developing a natural condition, prevents 
the extra curvature the other sustains, so that when 
labor comes upon her, the abdominal muscles, 
acting in harmony with the efforts of the uterus, 
effect an easy and quick birth, because no force nor 
effort is lost by being directed in a line deviating 
from the direction the child must take to make its 
exit. 

Another way in which tight-lacing becomes a 
cause of painful childbirth is by confining the 
movements of the diaphragm so as to enfeeble it ; 



62 PAINLESS CHILDBIRTH. 

at the same time the abdominal viscera are com- 
pressed into a space too small for the healthy 
performance of their functions, and being pre- 
vented from escaping upward, naturally gravitate 
downward, and by their pressure displacing the 
organs of the lower abdomen into the pelvis. The 
circulation is thus rendered defective, and the 
vitality of the pelvic organs being impaired, they 
become congested, sore, tender, irritable, painful, 
diseased — a condition of things that necessarily 
cause pain at childbirth. 

Deformities of the bony structures of the pelvis 
necessarily increase suffering, and imperil the lives 
of both mother and child in a direct ratio with the 
degree of deformity. In such cases, child-bearing 
should not be attempted, for when the deformity is 
so great that instrumental delivery is impossible, 
but one of two alternatives remain : Embryotomy 
or Cesarean section — the first of which sacrifices 
the child, and the second is pretty certain to sacri- 
fice the mother. 

Tumors within the pelvis retard and endanger 
delivery according to their situation, size and 
structure, and if they involve or press upon nerve 
filaments they occasion very great agony. Their 
removal must be effected before delivery. 

Inflammatory diseases of the WOIIlb necesarily 
increase the suffering. This organ is profusely 
supplied with nerves which are involved in the 
inflammatory process, and thus become acutely 



CAUSES OF PAIN. 63 

sensitive, as every woman who has been affected by 
it can testify. It is so sore and tender that the 
slightest touch is painful, much less the severe 
efforts of parturition. Inflammation also gives rise 
to another source of pain, a change in the structure 
of the tissue inflamed, by which its elasticity is 
greatly diminished. Occurring in the neck of the 
womb, it is easy to see how this may cause pain by 
interfering with the dilation of the mouth of the 
womb — a condition that must take place before the 
birth can occur. In its natural state, the circular 
muscular fibers that exist here are capable of great 
distention, but when rendered inelastic by the 
products of inflammation, the dilation is intensely 
painful, and may rupture the fibers. 

The employment of caustics, and incisions 
in the neck of the womb, for the cure of disease or 
removal of strictures, is apt to be followed by 
cicatrices which, being inelastic, are liable to un- 
equal dilation and an increase of pain. Xecessary 
as these practices may be, they are certainly open 
to this objection, high authorities to the contrary 
notwithstanding* Any one having a scar or cica- 
trix on their person knows that it will not stretch 
like other tissues, and is often very sensitive. Some 
writers have labored hard to prove that the tissues 
of the uterus were not subject to the same laws as 
tissues in other parts of the body, and consequently 
the results of inflammation, caustics and incisions 
would not affect the womb unfavorably, but it is 



64 PAINLESS CHILDBIRTH. 

certainly presuming very much upon the healing 
power of nature, to say the least. 

Any cause that can render any part of the 
generative apparatus sore, sensitive, and tender, 
whether inflammation, ulceration, swellings, com- 
mon leucorrh(Ba, diseases of the bladder, piles, and 
in fact anything that impairs the integrity of any 
tissue, whether of the generative organs themselves 
or adjacent structures, necessarily increases the 
suffering at the time of birth. Undue dryness 
of the passages may also be considered a cause, and 
can usually be overcome by artificial means. Any 
emollient or unirritating oily substance applied 
freely will answer. 

Anything that increases morbid irritability 
increases the suffering, which may be rendered 
intensely acute, even though not the slightest 
change of structure be visible. This increased 
sensibility is probably due to some change in the 
nerves themselves, which, in the present state of 
pathology, we are not able to appreciate. One 
thing, however, is certain ; that morbid irritability 
is a concomitant of exhaustion, and if the nervous 
system has been debilitated and irritated by mas- 
turbation or sexual excesses, an increase of suffering 
will be pretty likely to occur. 

Rigidity of the perineal muscles is apt to 
cause pain in the latter stages of the labor. Some- 
times the rigidity is so great that the perineum will 
rupture instead of relax, for the prevention of 



CAUSES OF PAIN. 65 

which slight superficial incisions have been jecom- 
mended. In this condition, anaesthetics are bene- 
ficial, and so are relaxants, if the management 
previous to this time has not been proper or 
effectual. (See subsequent chapters.) 

From the time when labor begins until it termi- 
nates, there is usually more or less continuous 
suffering of variable intensity, so that speedy 
delivery is desirable as a means of ending the 
suffering. The labor, however, should not be so 
short as to occasion the dangers alluded to in a 
previous chapter. 

The condition of the child as a cause of pain 
remains to be considered, and is of the very 
greates importance, because we have it in our 
power to control the- condition of which we are 
about to speak, without danger or detriment to the 
child or mother. 

The average weight of the newly-born child 
is said to be seven pounds — some are considerably 
smaller, others much larger. I have seen children 
live and thrive that did not exceed five pounds, and 
I have been present at several confinements when 
the child's weight exceeded ten pounds, and one 
instance when the child weighed fifteen pounds. 
Births are said to have occurred when the child 
has weighed eighteen pounds, but such instances 
are exceedingly rare, and must certainly be diffi- 
cult and painful. The reasons are obvious. 



66 PAINLESS CHILDBIRTH. 

Beyond a certain size, as the weight of the child 
increases under ordinary circumstances, the pain 
and difficulty of the labor increases. Dropsy of 
the head increases the trouble. Wherever the head 
will pass, if there is no deformity, the rest of the 
body will pass, the passage of the foetal head always 
being the most difficult and painful part of the 
entire process of parturition. The larger the child, 
of course, the larger the head will naturally be, so 
that it is a proper consideration to inquire how w r e 
may, with safety to both mother and child, control 
the growth of the child in utero, and we introduce 
the subject here because it has a direct bearing 
upon the suffering of the mother. It requires no 
argument to convince any one that while a small 
child may be born with little or no difficulty or 
pain, the same mother may find it absolutely 
impossible to give birth to a large child — to a child 
with a large head, or a deformed child. 

We now come to consider the bony develop- 
ment of the child as a cause of pain and diffi- 
culty at childbirth. It is often a subject of remark 
that the formation of bone in the skulls of some 
infants at birth is not nearly as far advanced as in 
others, and yet such children thrive equally well. 

At birth, the bones of the cranium have not 
been united by the ossific process, but admit of 
considerable mobility, so that by pressure the shape 
of the head may be materially changed, tem- 
porarily, without injury. Applying these observa- 



CAUSES OF PAIN. 67 

tions to the transit of the child through the 
maternal passages, and we speedily arrive at the 
conclusion that the softer, more spongy, cartila- 
ginous these bones are at birth, the more compressi- 
ble the head will be, and the more readily it will 
adapt itself to the passage, changing according to 
the necessity, while, if the process of ossification 
— bony development — is well advanced, such 
adaptability cannot take place, the labor will be 
more difficult, greater pressure will be necessary 
and more pain experienced. 

Everybody is well aware that a soft body or sub- 
stance the same size of a hard one will readily pass 
through an opening or tube through which the 
hard body cannot pass at all, or only with great 
difficulty. 

In the early stage of development, bones are soft 
and flexible, being composed of animal matter 
(gristle), but gradually become hard by the deposits 
of calcareous matter (lime) within their structure. 
All bones do not undergo this hardening process 
simultaneously, but it is completed in different 
bones at different periods of life. There seems to 
be no good reason why the bony system should 
have progressed beyond the cartilaginous stage of 
development at birth, for there is plenty of time 
after this event for osseous development before any 
very great necessity for the presence of bone will 
be experienced by the child. 



68 PAINLESS CHILDBIRTH 

It is a well-established fact in physiology 
and therapeutics that when bony development is 
tardy, and the bones are incapable of supporting 
the weight of the body, protecting its cavities, or 
preserving its symmetry, even when the process of 
teething is delayed, the administration of some of 
the preparations of lime as a medicine, or the 
selection of a diet containing considerable lime, is 
productive of good results. The lime administered 
artificially as medicine, or naturally as a food, sup- 
plies the deficient constructive element, and the 
development of bones goes on to completion. This 
being the case, the questions naturally arise : 

If we can increase the supply of bone-producing 
material when deficient, can we not dimininish it 
if excessive? 

If we can hasten development, can we not re- 
tard it ? 

If we can retard it after birth, can we not before 
birth ? 

If we can retard ossification before birth, then 
why can we not absolutely control the condition of 
the child's head and keep the bones sufficiently 
flexible to admit of easy delivery ? 

All these queries can be answered in the affirma- 
tive. Experiment has proven that such results are 
not only possible, but that they are safe and prac- 
tical. 

Nervous excitement may be a cause of pain. 
It is well known that some persons suffer far more 



CAUSES OF PAIN, 69 

from the same cause than others, and it is reason- 
able to suppose that the more nervous the woman 
is during gestation and delivery, the more intensely 
she will suffer. It is those who lead artificial lives 
or those whose constitutions have been shattered 
by disease, that are troubled with " nervousness " ; 
and, if no precautions are taken, it is reasonable to 
expect that such persons will suffer most at child- 
birth. 

Having briefly considered the most important 
causes of pain, in the subsequent chapters we shall 
endeavor to instruct the reader how to render these 
causes inoperative, and to remove the parturient 
female from their influence. 



70 PAINLESS CHILDBIRTH. 



CHAPTER V. 



HYGIENIC MANAGEMENT. 

The Objects of Hygiene — How Surroundings Affect Pregnant 
Women — How She Must Conduct Herself — What Exercise 
is Best, and How and When to Take it — Turning the Room 
Out Doors to Air it — The Difference between Bathing and 
Soaking — What Kind of Baths are Best, their Properties, 
etc. — The Sitz Bath — Sleep— Dress — The Spartan Law- 
How Sexual Influences Affect both Mother and Child — All 
Pain, "Difficulty and Danger Unnatural. 

The object of hygiene is to secure the most 
perfect health possible and prevent sickness. To 
this end it raay be necessary to place certain re- 
strictions upon our customary habits. We say 
restrictions because many of the habits we may 
have developed by artificial modes of life are apt 
to be inconsistent with perfect physical develop- 
ment. 

The special object in introducing the subject 
here is to secure for the mother the most perfect 
physical standard, and, at the same time, endow 
her unborn child with a perfect constitution. 

The pregnant woman should avail herself of 
every possible means to improve her physical 
health, and avoid every influence that can possibly 
fret, annoy, distress, or in any way injure her. 



stgienio management. 71 

/The husband, and those who habitually must 
associate with her, should endeavor to preserve the 
tranquillity of her mind, remove all sources of 
anxiety, relieve all annoyances, and by every pos- 
sible means contribute to her vigor, cheerfulness 
and happiness. y|Her associations should be of the 
most cheerful, pleasant, graceful and happy charac- 
ter, such as remove her mind from gloomy fore- 
bodings, anxiety, fear and selfishness. She should 
never be surrounded with any imperfections, nor 
be annoyed with the contemplation of misery, de- 
formity or unhappiness. She should never be com- 
pelled to hear stories of horror, which Dame 
Grundy so much delights to tell. 

Before important surgical operations are 
performed, more or less time is generally spent in 
putting the patient in the most perfect physical 
condition possible, that the system may be better 
able to bear the shock of the operation, a change 
that will result in diminishing pain and danger, 
and hasten recovery. If physical perfection is a 
matter of so much consequence under such circum- 
stances, how much more important it is when the 
welfare of two beings is at stake ? 

If conception occurs while the woman is nursing 
another child it should be weaned at once, for her 
physical forces will rarely, if ever, enable her to 
maintain both without impairing their vitality and 
injuring herself. 



72 PAINLESS CHILDBIRTH. 

The pregnant woman should not lead a life of 
indolence, nor should she, on the other hand, in- 
dulge in prolonged or violent exercise. Much must 
depend upon the natural vigor she possesses. 

Owing to the extreme liability of some women 
to miscarriage, they will find it necessary to avoid 
motion almost entirely. This no doubt proceeds 
from some local weakness or irritability that is 
aggravated by motion. Fortunately, such cases are 
rare, and the best treatment is quiet, with passive 
motion. This condition frequently disappears after 
a certain period of gestation has been reached. 

With this rare exception exercise is always 
beneficial, if moderately indulged, and is most 
beneficial when carried on in the open air, but 
should never, under any circumstances, be so active 
or long continued as to induce fatigue. Probably 
walking is the best form of exercise that can be 
taken, although when the pregnancy is far ad- 
vanced it may become so difficult and painful that 
it may be omitted. When, for any reason, walking 
is not advisable, riding in an easy carriage may be 
substituted. 

No matter whether she is to walk or side, care 
should be taken that it is agreeable and pleasant. 
There should be some agreeable, animating object 
in view. The woman must not be made to realize 
that the walk or ride is a forced routine. The 
mind as well as the muscles must be diverted, else 
the exercise becomes monotonous and tiresome — a 



B7GIENIG MANAGEMENT. 73 

damage instead of a benefit. The same road or 
path should not be selected each day ; the mind is 
to be occupied by new attractions ; a variation of 
scenery and circumstances. The exercise should 
be frequently repeated and not too long continued, 
and should be carried on in the open air in the 
sunshine. 

A gently active life is best calculated to preserve 
the health of the mother and her unborn child. 
The object is to increase and conserve the physical 
forces — to invigorate. Violent or prolonged exer- 
cise is to be avoided. Running, dancing, rowing, 
lifting, carrying heavy weights, as well as riding In 
uncomfortable or uneasy carriages, over rough 
roads or upon horse-back, are objectionable. Rail- 
way travel is unwise, the continuous jar of the cars 
being equally as dangerous as violent jolting. 

The nearer delivery approaches the more repose 
and quiet may be indulged. The use of the sewing 
machine should be discontinued. 

Pure air and plenty of it is the rule, and 
not only should the exercise be taken out of doors 
as much as possible, but the air of the rooms she 
occupies should be free from impurities. The air 
should be frequently changed, and is best done 
when the rooms are unoccupied. Give them fre- 
quent airings and avoid extremes of heat and cold. 
Perfect ventilation does not imply that the rooms 
are to be turned out of doors or the temperature 
reduced to the freezing point. A small opening at 



74 PAINLESS CIIILDBinTII. 

the top and bottom of the rooms will secure a con- 
stant change of air — a constant admission of oxy- 
gen and escape of carbonic acid gas — and yet the 
temperature may be maintained at an agreeable 
pitch. It is a mistaken notion that cold air only 
is pure. 

The apar tenants do not want to be dark. 
Let in the rays of the sun ; receive their vivifying 
influence. Plants will not thrive in the dark, and 
neither mother nor child can flourish without sun- 
light. Sun baths are decidely beneficial. Sit in 
the sun half an hour or more daily. Feeble women 
will find it an agreeable tonic. 

By exercising in the forenoon we get the use of 
the best physical strength, and at a time when every 
organ is in the best condition to profit by it. It is 
then that exercise is a pleasure. In the morning, 
exercise is apt to refresh. In the afternoon it is 
liable to fatigue. In the forenoon we are most apt 
to have sunshine, and the air is purest and most 
exhilarating. 

Bathing is beneficial when properly employed, 
but extremes must be avoided ; there is no sense in 
soaking a person to death on the one hand, nor 
completely obstructing the pores of the skin with 
dirt on the other. The temperature of the bath, 
the time of its employment and the object to be 
attained must always be considered. 

It is folly to suppose the same kind of bathing 
will answer every purpose, for bathing implies 



BYGIENIG MANAGEMENT. 75 

something more than mere cleanliness ; the tem- 
perature materially influences the result ; and 
while one woman may be greatly benefitted by a 
cold bath another will be injured by it. Those 
who have an abundance of vitality will find the 
cool, or even cold bath beneficial and agreeable, 
while those of a feeble constitution may be so 
chilled and injured by it that reaction failing to 
occur, serious internal congestions, and even fatal 
consequences may follow. 

As a rule, bathing should be agreeably tempered 
to suit, varying from cold to hot, partial or com- 
plete, plunge, tub, sponge, douche, sitz, etc. 

Probably the temperate, or tepid bath will be 
suitable for the greatest number. Immediately 
after emerging from it, the body should be rubbed 
thoroughly dry with a coarse towel, that proper 
reaction be induced. Usually, the bath may be 
continued from three to ten minutes, and the lower 
the temperature the shorter duration. 

Cool baths are most beneficially employed in the 
fore part of the day, the object being mainly to 
secure its invigorating effect, while the warm bath, 
on account of its soothing, calming influence, is 
most beneficial in the latter part of the day or 
evening. 

Women who have previously been in the habit 
of cold, plunge or shower baths should not discon- 
tinue them now; but if they have never accus- 
tomed themselves to them it is doubtful if it is best 



76 PAINLESS CHILDBIRTH. 

to begin them while in this condition, lest the 
shock they occasion cause miscarriage. 

The temperature of the different kinds of baths 
varies considerably, as will be seen from table : 

Cold bath 30° to 60° Fakr. 

Cool bath - - - 60° to 75° " 

Temperate bath - - - - 75° to 85° " 

Tepid bath - 85° to 92° " 

Warm bath ... 92° to 98° " 

Hot bath .... 98° to 110° " 

Nervous women will find that a warm bath, 
taken just before retiring, will allay irritability, 
nervousness, and induce agreeable sleep. It mod- 
erates pain and soothes the entire system ; and if 
not continued too long will not debilitate, but 
rather invigorate. Bathing should not usually be 
indulged in while digestion is going on. 

Baths may be medicated or not, as desired. For 
the purpose of cleanliness, the tepid sponge bath is 
most available, though the sponge employed briskly 
in the morning, moderately cool, and followed im- 
mediately by a brisk rubbing, is to be commended ; 
and those who have not the facilities for immersing 
the whole body will find it an excellent way to 
apply the tepid or warm bath at night. 

With reference to the employment of the sitz 
bath we cannot do better than quote from the well- 
known author, Dr. Shew : 

Pregnant women receive much benefit from a constant use of 
this bath. A small tub of sufficient size, set upon a very low 
stool, or anything by which it can be raised a few inches,, is 



HYGIENIG MANAGEMENT. 77 

quite sufficient. Unpainted wood is the best material, metal 
being unpleasant and cold. The water is used from one to five 
or six inches deep. The length of time this bath is used varies 
from a few minutes to two hours or more. To avoid exposure 
to cold it is best to uncover only the part of the person to be 
exposed to the water. This bath has the effect of strengthening 
the nerves, of drawing the blood and humors from the head, 
chest and abdomen, and of relieving pain and flatulency, and i3 
of the utmost value to those of sedentary habits. It is sometimes 
well to take a foot bath, tepid or cold, at the same time. If a 
large quantity of cold water were used in this bath, it would 
remain cold too long, and thus drive the blood to the head and 
upper part of the body, which might be very injurious; but the 
small quantity of water used at once becomes warm and thus 
admits of speedy reaction. In some local diseases of the lower 
parts, when there is inflammation, and the cold water feels most 
agreeable, the water is frequently changed. If there is any in- 
clination to headache, or too much heat in the head, a cold 
bandage upon the forehead' and temples is good. It is often 
well to rub the abdomen briskly during this bath. The sitz 
bath may be used by any person, whether in health or other- 
wise, without the slightest fear of taking cold. Let those subject 
to giddiness, headache or congestions of blood in the upper 
regions try this, and they will at once perceive its utility. In 
those troublesome itchings which often afflict pregnant women, 
this application may be made as often as the symptoms occur, 
and will be found a sovereign remedy 

It is not desirable tnat~~any shock should be 
given the system, and the temperature at which 
the bath is begun should usually be about that of 
the tepid bath. It can be employed at any time of 
day, and is agreeable in the evening at such times 
as when the warm general bath is not being used. 

Plenty of refreshing sleep is essential to the 
welfare of both mother and child. At least, eight 



78 PAINLESS CHILDBIRTH. 

hours is advisable. It favors the tranquillity of 
both mind and body, and not only relieves the 
uneasiness and inconvenience sometimes attending 
this condition, but is a potent preventive of habit- 
ual miscarriage. The sleeping room should be 
quiet and airy, neither too warm nor too cold ; the 
bed moderately hard ; the covering light, but suf- 
ficient to prevent chilliness ; mattresses are to be 
preferred and feathers prohibited. Occasionally, a 
nap during the day is admissible, and frequent 
rests desirable ; but in resting, it is not best to sit 
on cushions, for, by the warmth of the body they 
occasion, they induce congestion of the pelvis, a 
condition particularly to be prevented. 

The dress should be loose and comfortable, and 
so arranged that unequal pressure is avoided. It 
should be suspended from the shoulders instead of 
the waist and hips. Stays and corsets, if worn at 
all, must be loose enough to admit of perfect free- 
dom of the abdominal muscles, and after the fifth 
month had better be laid aside. It would be better 
for all women if they would never wear corsets, 
for they impair the power of the muscles they 
surround. 

Any attempt to conceal her condition by lacing, 
stays or tight dresses cannot be too severely con- 
demned, and will be certain to be followed by bad 
results, which, in many instances, will not admit of 
a remedy. The Spartan law directed that preg- 



HYGIENIC MANAGEMENT. 79 

nant women should wear large dresses, so as not to 
prejudice the free development of the precious 
charges of which nature had rendered them the 
momentary depositories. 

Care should be taken that the breasts are not 
pressed upon, nor injured in any way. 

Flannel underclothing is always best, unless in 
the few exceptional cases where the skin is exceed- 
ingly sensitive. 

In no case should tight garters, if indeed any, be 
worn, on account of their tendency to obstruct the 
circulation and cause cold feet and the knotted 
condition of veins, that give so much trouble sub- 
sequently. 

The sexual relations at this time should be of 
the most moderate character, for it certainly will, 
if freely indulged, exhaust the mother and impair 
the vitality of the child, inducing in its constitution 
precocious sexual development. (The mind should 
be free from the subject, and every circumstance 
that has a tendency to promote desire should be 
studiously avoided. For this reason, separate beds 
and even sleeping rooms for both husband and 
wife are to be recommended. On the other hand, 
ungratified desires, where so great as to gain con- 
trol of the mind, are liable to mark the foetus with 
an insatiable appetite. It is for this reason we 
counsel moderation, and believe the moderate 



80 



PAINLESS CHILDBIRTH. 



gratification of any appetite, when consistent with 

reason, is better than absolute denial. Temperance 

is the best conservator of health and pleasure. 

" Just in proportion as the mother observes the laws of health, 
so will the labor be short or protracted, hard or easy. Just as 
life is natural, labor is natural, and a natural labor is not painful 
or dangerous. The organic nerves which supply. the uterus are 
never sensitive in a healthy state. It is only in disease that they 
have pain. All the pain, difficulty and danger of childbirth is 
the resuli of disease. Banish disease and we rid ourselves of its 
consequences." 




1— ST 



^ 
^ 



DIETETIC MEASURES. 81 



CHAPTER VI. 



DIETETIC MEASURES. 

Composition of the Different Kinds of Food — How the Mother's 
Food Affects Childbirth — The First Experiment and How it 
Resulted — A Very Liberal Dietary — Food that Contains 
Phosphate of Lime is to be Carefully Avoided — Acids — The 
English Lad} T 's Experiment — Must the Mother Eat for Two 
— The Extra Amount of Nourishment Required. 

Since the composition of different kinds of 

food has been determined by chemical analysis, 
the influence of diet upon physical conditions is 
capable of comprehension, and there no longer 
remains any doubt of the importance of a well- 
selected diet in pregnancy. It has been proved 
that at least some of the unpleasant phenomena 
attending this condition can be overcome or 
avoided by a properly regulated diet. 

We have already had occasion to allude to the 
influence bony development of the foetus exerts 
upon the ease or difficulty of childbirth, and it is 
now appropriate that we consider the relation of 
diet to bony or osseous development. It is 
well known to physiologists that the various struct- 
ures of the bod}' are elaborated from the materials 
supplied by the food, and that if certain nutritive 
elements are deficient, those structures into the 



82 PAINLESS CHILDBIRTH. 

composition of which they enter, must necessarily 
be defective. 

Bones are composed very largely of calcare- 
ous or earthy matters, and the process of ossification 
is not completed in all the bones until the indi- 
vidual has reached adult life. 

In the early stages of foetal life, what afterwards 
becomes bone is in a state closely resembling gristle, 
and it is not until several months have elapsed that 
the deposit of earthy matters takes place in this 
gristly substance, but so rapidly does it then take 
place that at birth some of the bones have ac- 
quired considerable hardness, and thus preserve 
the form and shape of the child. This bony de- 
velopment, therefore, we desire to retard, in order 
to render the birth easy ; and as the earthy sub- 
stances that form bone, as well as the materials 
that compose the other structures of the child, 
must necessarily be derived from the blood of the 
mother, and her blood in its turn be supplied by 
her food, the question naturally presents itself: 
Why cannot the food of the mother be selected so 
that there shall be a sufficiency of all the nutrient 
materials except that which occasions the harden- 
ing of bones ? 

So far as we know, this subject was first brought 
to public notice by an English chemist named 
Rowbotham, by the publication of a small pamphlet 
in 1841. This pamphlet is now out of print, but 
the principles it contained have been made the 



DIETETIC MEASURES. 83 

central idea of a treatise entitled, Parturition With- 
out Pain, by M. L. Holbrook, M. D., to which very 
valuable little work I am greatly indebted for 
many important suggestions. 

Mr. Rowbotham's idea originated from read- 
ing the physiology of the development of the 
foetus, from which he reasoned that the calcareous 
substances being deposited from the mother's blood, 
a diet deficient in this element would materially 
affect the character of the birth. His wife having 
suffered severely in two previous births he deter- 
mined to try the experiment of a restricted diet, 
w T ith the hope of relieving her suffering, and the 
result being so satisfactory he made it public 
in the pamphlet referred to above. 

She had, on this occasion, two years and a half after the last 
delivery, advanced full seven months in pregnancy before she 
commenced the experiment, at her husband's earnest instance ; 
her legs and feet were, as before, considerably swelled, the 
veins distended and knotty, and her health diminishing. 

She began the experiment in the first week of January, 1841. 
She convinced by eating an apple and an orange the first thing 
in the morning and again at night. This was continued for 
about four days, when she took just before breakfast, in addition 
to the apple and orange, the juice of a lemon mixed with sugar, 
and at breakfast two or three roasted apples, taking a small 
quantity of her usual food, viz. : wheaten bread and butter. 
During the forenoon she took an orange or two and an apple. 
For dinner she took fish and flesh in small quantities, and pota- 
toes, greens and apples — the apples sometimes peeled and cut 
into pieces, sometimes boiled whole, along with potatoes, some- 
times roasted before the fire and afterwards mixed with sugar. 
In the afternoon she sucked an orange, or ate an apple or some 
grapes, and always took some lemon juice mixed with sugar or 



84 PAINLESS CHILDBIBTH.) 

4 

treacle. At first the fruits acted strongly on the stomach and 
intestines, but this soon ceased, and she could take several 
lemons without inconvenience. For supper she had again 
roasted apples or a few oranges and rice, or sago boiled in milk ; 
sometimes the apples peeled and cored were boiled along with 
the rice and sago. On several occasions she took for supper 
apples and raisins or figs, with an orange cut among them, and 
all stewed together. Two or three times a week she took a tea- 
spoonful of a mixture made of the juice of two oranges, one 
lemon, half a pound of grapes and a quarter of a pound of sugar 
or treacle. The sugar or treacle served mainly to cover the taste 
of the acids, but all saccharine matters are very nutritious. The 
object of giving these was to dissolve,, as much as possible, the 
earthy or bony matter she had taken with her food during the 
first seven months of her pregnancy. \ 

She continued in this course for six weeks, when, to her sur- 
prise and satisfaction, the swelled and prominent state of her 
veins, which had existed before she began, had entirely sub- 
sided ; her legs and feet, which were also swelled considerably, 
had returned to their former state, and she became so light and 
active she could run up and down a flight of more than twenty 
stairs with more ease than usual, when she was perfectly well. 
Her health became unwontedly excellent, and scarcely an ache 
or a pain affected her up to the night of her delivery. Even her 
breasts, which, at the time she commenced the experiment, as 
well as during her former pregnancies, were sore and tender, 
became entirely free from pain, and remained in the very best 
condition after her delivery and during her nursing. 

At nine o'clock on the evening of March 3d, after having 
cleaned her apartments, she was in the adjoining yard shaking 
her own carpets, which she did with as much ease as any one 
else could have done. At half-past ten she said she believed her 
time had come, and the accoucher was sent for. At one o'clock 
the surgeon had left the room. He knew nothing of the experi- 
ment being made, but on being asked, on paper, by the husband, 
two days afterward, if he " could pronounce it as easy and saf o 
a delivery as he generally met with," replied, on paper: "I 
hereby testify that I attended Mrs. Rowbotham on the third in- 
stant, and that she had a safe labor and more easy than I gener- 
ally meet with." On his asking the female midwife if she 



DIETETIC MEASURES. 85 

thought it as easy as usual, replied : " Why, I should say that a 
more easy labor I never witnessed ; I never saw such a thing, 
and I have seen a great many labors in my time." 

"The child — a boy — was finely proportioned and exceedingly 
soft, his bones were all in gristle, but he became of large size and 
very graceful, athletic and strong as he grew up. The diet of 
his mother was changed on his birth, and she ate bread and milk 
and all articles of food in which phosphate of lime is found, 
and which had been left out before. She also got up from her 
confinement immediately and well. After her last delivery, in 
July, 1838, full ten days elapsed before she could leave her bed, 
and then she swooned at the first attempt. On this occasion, 
March, 1841, she left her bed on the fourth day, and not only 
washed but partly dressed herself. Had she not been influenced 
by custom and somewhat timid, she might have done so sooner. 
To be assisted appeared like a burlesque to her, not to say 
annoyance. She had no assistance from medicine. In the 
former pregnancy she had subsisted very much on bread, 
puddings, pies and all kinds of pastry, having an idea that solid 
food of this kind was necessary to support and nourish the f cetus, 
and it is quite right to suppose that nutritious food is necessary 
for this purpose ; but nutritious food can be had without that 
hard and bony matter which is so large an ingredient in wheaten 
flour. For instance, the West India grains, sago, tapioca, rice, 
etc., have little of it; and Mr. Rowbotham made a table of 
substances with the proportion of phosphate of lime in each, so 
that it may be avoided in the food during pregnancy and used 
afterwards in nursing when the bones and teeth are made. 
Wheat contains most earthly matter. 

" Beans, rye, oats, barley, have not so much earthly matter as 
wheat ; potatoes and peas not more than half as much; flesh of 
fowls and young animals, one-tenth; rice, sago, fish, eggs, etc., 
still less; cheese, one-twentieth; cabbage, savoy, brocoli, arti- 
chokes, cole worts, asparagus, endives, rhubarb, cauliflower, 
celery and fresh vegetables generally, turnips, carrots, onions, 
radishes, garlics, parsley, spinach, small salad, cucumbers, leeks, 
beets, parsnips, mangel-wurtzels, mushrooms and all kinds of 
herbs and flowers average less than one^fifth; apples, pears, 
plums, cherries, strawberries, gooseberries, raspberries, 
cranberries, blackberries, huckleberries, currants, melons, olives, 



86 PAINLESS CHILDBIRTH. 

peaches, apricots, pineapples, nectarines, pomegrantes, dates, 
prunes, raisins, figs, lemons, limes, oranges and grapes, on an 
average, are two hundred times less ossifying than bread or 
anything else prepared of wheaten flour." 

With such an extensive list of non-ossifying 
edibles to select a dietary from, and the culinary- 
ingenuity of most women, it does not seem that the 
appetite for preparations of wheat would be very 
difficult to appease. A varied diet is absolutely 
essential to health, and an occasional meal, of 
which wheat bread forms a part, may be permitted, 
more particularly in the early months of gestation, 
but in the three latter months, when ossification is 
going on, the more carefully the diet is selected to 
exclude phosphate of lime the better. 

There is no danger of injury to the mother or 
child by this dietetic course, for it is impossible to 
exclude all calcareous matter, yet the quantity can 
be so diminished as to retard instead of favor ossifi- 
cation. The list as quoted above may not be 
absolutely correct, yet as the fruits that are most 
advised contain so much acid that they probably 
hold the calcareous matters in solution and pre- 
vent their deposition, consequently the list is prac- 
tical and the results satisfactory. 

As regards drinks, in many sections the water 
contains, in solution, considerable quantities of 
lime — the water is hard — consequently rain, or 
snow waters are best. Boiling such hard water be- 
fore using will cause the precipitation of considerable 



DIETETIC MEASURES, 87 

of the lime, as may be observed by the formation of 
the crusts in the tea-kettle. When it is necessary 
to use hard water it should be boiled and 
cooled before using for cooking or drinking. Tea 
and coffee may be moderately indulged in, and of 
the two tea is least objectionable. Cocoa contains 
less lime than coffee, though coffee is a good nutri- 
ment with this one exception. Lemonade or 
drinks made of acid fruits, jellies, etc., are unob- 
jectionable, and the acids they contain will, to a 
certain extent, hold the earthy or calcareous bony 
matters in solution and oppose their deposition. 

Women living upon the foregoing diet will have 
little desire for much drink of any kind. 

Swelling of the feet and limbs rarely occurs when 
the fruit diet is employed, and cases suffering from 
such difficulty when the diet is begun will generally 
experience decided relief. 

There has been no objection offered to animal 
food. Indeed, we would advise that it form at least 
a small portion of the diet, particularly in debili- 
tated and feeble women, but in those of full habit it 
had better be sparingly eaten, as it is heating, while 
the acid fruits are cooling. Lamb, veal, chicken 
and fish are the most appropriate meats for this 
condition. 

Inordinate and capricious appetites for improper 
and noxious articles should, of course, be opposed, 
but when the longings can safely and properly be 
indulged it should be gratified. With the diet list 



88 PAINLESS CHILDBIRTH. 

advised very little, if any, annoyance is to be 
apprehended. 

The benefits to be secured by a well-regulated 
diet are not merely hypothetical, but have been 
fully substantiated by experiment. Soon after the 
publication of the pamphlet referred to, an English 
lady of high respectability resolved to profit by the 
idea, and as soon as she thought she was pregnant 
she abandoned bread, potatoes and milk and sub- 
sisted on the West Indian grains, rice, tapioca and 
sago, fruits of all kinds and vegetables, and when 
she ate meat she ate that which was young, drank 
lemonade and tea, both of which were made of 
distilled water. She did not suffer an hour's incon- 
venience during the whole time, the birth was easy, 
and the child, though very soft at first, grew rapidly 
and became large and strong. 

Numerous others have tried it that we know of 
and have been reported by others, and not a few 
have come under our own observation, in all of 
which the results are mainly the same. Several 
have tried the plan at my suggestion and the 
results have, in every instance, been highly satis- 
factory. 

Those nations among which childbirth is com- 
paratively easy, subsist mainly on a diet in which 
bony materials are very limited. Females of 
tropical climates, where the diet is very largely 
fruit, suffer very little at childbirth. The American 



DIETETIC MEASUBES. 89 

Indians eat very little wheat, and the same is true 
of the colored slaves of the South. 

It is a very popular but erroneous idea that 
the mother must gorge herself throughout preg- 
nancy in order to support and nourish the unborn 
— that she must " eat for two." This is a very great 
mistake. On the contrary, instead of eating more 
than she wants she should be governed by the 
dictates of hunger, and never eat an extra mouth- 
ful. The amount of nourishment the foetus requires 
day by day is very trifling indeed. As a result of 
such a mistaken notion she disorders the stomach, 
becomes heated and feverish, is troubled with head- 
ache and dizziness, and lays herself liable to 
numerous intestinal disorders ; and if assimilation 
is active in proportion to the increased amount 
eaten, she becomes extremely fleshy and uncomfort- 
able, and will be liable to much annoyance from 
swelling, cramping or numbness of the extremities. 

Figure the matter out for yourselves : The aver- 
age duration of pregnancy is two hundred and 
eighty days ; the average weight of the child and 
placenta {afterbirth) does not exceed ten pounds, and 
generally not over eight ; then ten pounds give one 
hundred and sixty ounces, or but little more than 
half an ounce a day is required. 

Admitted that during the first four months the 
amount required will be much less than in the last 
four, as we more nearly approach delivery, the 
greater will the amount required become ; never- 



90 PAINLESS CHILDBIRTH. 

theless, the average remains the same. Laying the 
question of average aside, there is no use of the 
mother commencing to lay in a surplus for at least 
the first six months, though during the last three 
the amount of nourishment might be slightly in- 
creased. She should also bear in mind that if by 
excessive eating she increases the nutrition of her 
child, she increases iis growth, and for every ounce 
she increases its development beyond a given point, 
she unwisely diminishes the ease of delivery. 

Numerous authorities might be cited on the sub- 
ject, but we do not regard them necessary ; the 
proposition is of too easy comprehension to require 
argument, and unless morbid conditions supervene 
to require a modification of the amount eaten for 
therapeutic purposes, the dictates of hunger will be 
Dy far the best guide how much will be best, always 
bearing in mind, let moderation in all things 
prevail. 



REMEDIAL TREATMENT. Q\ 



CHAPTER VII. 



REMEDIAL TREATMENT. 

Diseases Must be Cured — An Indian Tradition— What the 
Squaws do — Squaw Vine — A Favorite Preparation and What 
it cures — The Properties of Blue Cohosh — Its Power to Pre- 
vent Pain and Miscarriage — Proof that Remedies Prevent 
Painful Labor — Mother's Cordial — Experience of Physicians 
—The Value of Black Cohosh — How these Medicines are to 
be Used — Management of Constipation — The Kidneys Must 
be Kept Healthy — What Causes Morning Sickness — The 
Fallacy of its Necessity — Shall Longings be Gratified or Not 
— Flatulence and Colic — Varicose, or Knotted Veins — Heart- 
burn — Piles — Shall Diarrhoea be Checked — Other Symptoms — 
The Sleeping Room — Pressure of the Womb on Veins — Abor- 
tion — Erroneous Idea — How Maternal Responsibilities are 
Evaded — Legal Consideration — Is the Crime Justifiable — Pre- 
vention of Conception, or Abortion — It is Murder — Its Effect 
upon the Woman — Unintentional Causes — Premonitory and 
Actual Symptoms — Hemorrhage the Greatest Immediate Dan- 
ger — My First Case — Preventive Measures and When Necessary 
— Nervousness — Sore Nipples — Leucorrhcea — Important Ad- 
vice — False Pains Distinguished from True Ones — Intense 
Suffering from Irritable Bladder. 

Although the measures already advised are of 
the utmost importance, and will certainly exert a 
powerful influence over the ease and safety of deliv- 
ery, the mother's recovery and the future welfare 
of the child, there remains to be considered other 
agencies, in the efficacy of which we have almost 
unlimited confidence — agencies which exercise a 
positive curative influence over those abnormal 



92 PAINLESS CHILDBIRTH. 

conditions that so frequently attend, or co-exist 
with pregnancy, and which so often complicate 
and increase its difficulties* 

These agencies — therapeutic in character — 
may be employed in conjunction with the hygienic 
and dietetic measures already detailed, and will 
act in perfect harmony with them, and mutually 
increase the value of each other. 

We have seen the dietetic and hygienic measures 
employed alone with the most decided benefit; and 
have, in other cases, tried the therapeutic treat- 
ment, we are about to advise — when the other could 
not be made available — with the effect of rendering 
the labor short, easy and safe, as well as controlling 
any unpleasant symptoms that presented during 
the progress of the pregnancy. 

All women are not affected in the same 
manner — all constitutions are not alike — and we 
will often observe pathological conditions occurring 
during pregnancy, which had their origin long 
before the conception took place, or pathological 
conditions may be developed during gestation. 
There may be abnormal conditions which do not 
depend for their present existence, nor are in any 
way connected with pregnancy, yet, if allowed to 
proceed, will seriously militate against a short, easy 
or safe delivery. Again these morbid conditions 
may have an intimate connection with the gesta- 
tory, or pregnant state. The present and future 
welfare of both mother and child necessarially 



REMEDIAL TREATMENT. 93 

depend greatly upon our ability to control or 
remove these conditions. 

At the risk of seeming inconsistent, or of appear- 
ing to lack confidence in what I have already 
written and advised in the preceding chapters, I 
shall consider those remedial agents which have 
in my hands and in the hands of my professional 
acquaintances, accomplished so much for the relief 
of suffering woman. 

There is a tradition that the Indian women 
of this country, for two or three months prior to 
to delivery, resort to drinking an infusion of a 
plant known as squaw vine or partridge berry, in 
order to render their delivery easy and safe. 
Whether this tradition has any foundation in fact 
or not, I do not know, nor does it seem that I need 
care, so long as the tradition has developed a 
knowledge of a remedy of the greatest possible 
consequence to the parturient female. Whether 
the squaws drink it or not, there is nothing more 
certain to my mind, than that it does possess the 
truly wonderful and beneficent properties ascribed 
to it. 

In the American Dispensatory, by Dr. John King, 
we find the following reference to it : 

It is said that the squaws drink a decoction of the plant for 
several weeks previous to their confinement, for the purpose of 
rendering parturition safe and easy. ******** 
Partridge berry is parturient, diuretic and astringent, used in 
dropsy, suppression of urine and diarrhoea. It seems to have a 
special affinity for the uterus, and is highly beneficial in all 



94 PAINLESS CHILDBIRTH 

uterine diseases. It appears to exert a powerful tonic aud alter- 
ative influence on the uterus. Dose of the strong decoction, 
from two to four fluid ounces, two or three times a day. The 
berries are a popular remedy for diarrhoea and dysuria. It is 
highly recommended as a remedy for sore nipples, used as fol- 
lows : Take two ounces of the herb, fresh, if possible, and make 
a strong decoction with a pint of water ; then strain and add as 
much good cream as there is liquid of the decoction; boil the 
whole to the consistency of a soft salve, and when cool, anoint 
the nipples with it every time the child is removed from the 
breast. 

Hale, in his New Remedies, says : 

I would recommend it for false pains, uterine irritability, 
scanty and delaying menses, dysuria and scanty urine with 'profuse 
sediment. 

Iii procuring this remedy it is best to obtain it 
by its botanical name, Mitchella Repens, as there are 
several plants known in different parts of the 
country by the name of squaw vine, squaw berry, 
squaw mint, partridge berry and other similar 
names, which would have a tendency to confuse 
any one not familiar with botany, and it is neces- 
sary to get the right plant. 

An infusion is always the best form for adminis- 
tration, and will be found most efficacious, for I 
must confess, though I have tried several specimens 
of fluid extracts, they have failed to afford the satis- 
faction I have derived from the infusion of the 
recently gathered plant. It is advisable not to 
rely on the plant that has been gathered more than 
a year, as it is apt to lose its strength and become 
inert if kept longer. 



REMEDIAL TREATMENT. 95 

The action of this remedy, either alone or in 
combination, is to act gently upon the kidneys and 
urinary organs, relieving irritability and moder- 
ately increasing the flow of urine. It cleanses the 
blood, soothes any nervous excitement that may 
exist, removes pain and soreness, and effectually 
overcomes any morbid inflammatory conditions of 
the female reproductive organs, strengthens the 
uterus and establishes such a healthy condition as 
results in an easy and safe delivery. ' 

When the lower extremities are swollen, 

as is often the case after the pregnancy is well ad- 
vanced, owing to an obstruction of the circulation, 
I have seen this remedy produce the most decided 
and speedy relief. I have given it in the treatment 
of various uterine disorders with the most satisfac- 
tory results, but the consideration of those complaints 
having been made in this edition, the subject of a 
separate chapter, further allusion to such use of it 
at this time is unnecessary. 

There is another plant that possesses a sim- 
ilar and deserved reputation, and I have frequently 
combined them with the happiest results. I allude 
to blue cohosh, the botanical name of which is 
Caupolhyllum Thalictroides, also known as squaw 
root, of which Dr. Hale, in his recent popular work 
on New Remedies, says : 

The aborigines and early settlers claimed for it the power of 
preventing tedious and painful labors. This testimony has been 
substantiated by many prominent and trustworthy physicians of 



96 PAINLESS CHILDBIRTH. 

the eclectic school, as well as of the homoepathic. A few of 
our school have denied it such power, but the weight of evidence 
is against them. Dr. A. E. Small is sure, from the observation 
of many years, that it actually prevents the usual sufferings 
which many women undergo. He also testifies to the singular 
fact that many women who have taken it for such purposes have 
overrun their time to the extent, in some cases, of ten or twelve 
days. The cases referred to, however, all had very easy labors 
and a good recovery. 

My experience has been so uniform and conclusive on this 
point that I do not hesitate to assert that it prevents not only a 
too painful labor, but it prevents those premature labors which 
are so common among the weakly women of this age. 

I have repeatedly used a combination 

of the two with the most satisfactory results. I ob- 
tained the fresh materials and administered them 
in the form of a sweetened infusion, sometimes 
adding other agents that seemed specially de- 
manded. In very many instances have I made use 
of these remedies in cases which had hitherto 
undergone the most terrible sufferings at parturi- 
tion, with the effect of enabling the mother to have 
a very speedy delivery, almost absolutely free from 
pain. In those females who had taken it there was 
very little of the inconvenience usually experienced 
in the latter months of gestation ; the mother made 
a wonderfully speedy recovery, and, in some in- 
stances, were entirely relieved of uterine disorders 
to which they had for several years previously been 
subject. 

While practicing medicine in the central part of 
the State of New York, so favorable were the re- 



REMEDIAL TREATMENT. 97 

results attained by using the foregoing remedies in 
the form of sweetened infusions which I then pre- 
pared, the remedy acquired such a reputation that 
very many parturient women procured it that they 
might go through childbirth without pain ; and 
though it was taken in hundreds of cases where I 
could not attend the confinement, I have never 
known of a single instance of failure; but, on the 
contrary, received many testimonials of its efficacy 
and thanks for the benefits derived from it. There 
are many women who will remember taking what 
I then termed the " mother's cordial," the composi- 
tion of which I did not reveal to them, but which 
consisted mainly of an infusion of the squaw vine 
and blue cohosh, preserved with sufficient sugar 
and alcohol to render it palatable and secure its 
preservation while being used. 

In using an infusion of these plants an ounce of 
the squaiv vine and half an ounce of blue cohosh 
should be steeped in a pint of water and the whole 
taken in the course of three or four days. "When 
one is used alone a greater quantity should be em- 
ployed than when both are used together. 

A very convenient and agreeable combi- 
nation may be made thus : 

Squaw Vine, .... 3^2 pound. 
Blue Cohosh, 3i pound. 

Bruise them thoroughly and add one gallon of water, and let 
them stand over night. Then heat them nearly to the boiling 
point and gradually reduce the quantity of liquid (occasionally 
letting it come to a boil), to one half> strain and press out all the 



98 PAINLESS CniLDBIBTH. 

liquid, which should measure three pints, add 1 pound of loaf 
sugar and dissolve ; then add spirits to make the whole meas- 
ure two quarts. The dose should be a table spoonful three to 
five times a day. The spirits are only added to preserve the 
preparation and need not be added when the infusion is made 
in small quantities to be used before it would sour. In cold 
weather a less quantity of spirits will suffice. Whisky, gin or 
alcohol may be used. 

There is still another plant that is indigenous 
to this country which enjoys a growing reputation, 
not only for the relief of those morbid conditions 
that render gestation and delivery painful and 
tedious, but as a remedy to expedite delivery. I 
refer to the black cohosh, or Cimicifuga Bacemosa, also 
known as Macrotys. Given in small doses for two 
or three weeks, there can be little doubt that it has 
the power of rendering the labor very short and 
easy. 

Dr. Scudder, of Cincinnati, editor of the Eclectic 
Medical Journal, speaks positively on the subject as 
follows : 

Pregnancy is a physiological condition, and tliere should be 
little or no pain, ache or unpleasantness associated with it. If 
there is it should be looked after at onco and removed. These 
unpleasantnesses can and should be relieved for the comfort of 
the mother, and mora especially because this will probably ren- 
der the laboi easier and the getting up better. Let me again 
call attention to macrotys as partus preparatory though doubtless 
most of our reader have tested it. If there are pains and aches 
in the region of the uterus, tenderness on pressure, or soreness 
at any part of the uterine globe ; if the movements of the child 
are painful, or there is pain in the pelvic articulations ; or, finally, 
if during the last month there are false pains, macrotys is likely 
to be a remedy. I have used it time and again in these cases with 



REMEDIAL TREATMENT, 99 

relief, and in others during the last six or eight weeks of gesta- 
tion, simply to facilitate and make the labor easier, and I am 
satisfied with good results. 

In Hale's New Remedies the author makes the 
following allusion to it : 

Dystocia (difficult labor) is one of those abnormal conditions 
which come under the domain of homeopathic medication. It 
is useless to cling to the antiquated superstition that a woman 
must suffer the " pangs of childbirth." Dystocia is always the 
result of an abnormal condition of the tissues concerned in the 
functions of childbearing. ******* 
I have attended many women whose previous labors had been 
exceedingly painful — almost unendurable without ether — but, 
owing to the administration of cimicifuga during the last weeks 
of pregnancy, they suffer very little So many of these cases 
have occurred in my practice and in that of my colleagues, that 
it is not proper to affect skepticism or unbelief. As a rule, first 
labors are painful and protracted, while subsequent ones are less 
so ; but if five or six are very painful, and each one seems to be 
more painful than the last we cannot expect the seventh to be 
painless except from some remedial interference. Now, if in 
such cases cimicifuga, caulophUum or viburnum is given, and the 
woman's next labor is easy, what are we to think ? Evidently, that 
the medicine effected a change of condition from abnormal to 
normal. 

In such cases give the cimicifuga at least two weeks previous 
to the expected date of labor, in doses of one to ten drops, two 
or three times a day, the doses repeated oftener as the date ap- 
proaches. 

The preparation alluded to by Prof. Hale is the 
homeopathic mother tincture, and when it can be 
obtained will represent very certainly the virtues 
of the drug. An infusion of the root, one-half 
ounce in a pint of boiling water, of which the dose 
may vary from a teaspoonful to a tablespoonful, re- 



100 PAINLESS CniLBBIMTIT. 

peated three or four times a day, will also answer. 
The fluid extract, when reliable, in doses of from 
three to eight drops may be used. When the 
homeopathic tincture cannot be readily obtained, 
the following procedure will answer: 

Black Cohosh Boot, J£ pound. 

Alcohol, J^ pint. 

Bruise the cohosh as fine as possible, and put it in the alcohol, 
cork and let it stand a week or two, occasionally shaking the 
same. At the end of this time it may be strained and used in 
doses as advised for homeopathic tincture. 

Were I going to use it without having used either 
of the other remedies, I would advise that its em- 
ployment be given earlier, say at least two months 
before delivery. 

If too much is taken it will produce an unpleas- 
ant fullness in the head. 

The condition of the bowels must be looked 
after, and any disposition to constipation overcome. 
If the woman is of full habit and costive, I would 
advise a small quantity of Epsom salts daily, just 
enough at a dose to produce a free, natural evacua- 
tion. They cool the system, relieve determination 
of blood to the head with dizziness, swelling of the 
feet, etc., prevent nausea and a host of the disorders 
that attend constipation. We are well aware the 
taste of salts renders them objectionable to very 
many. When such is the case they may be dis- 
guised and their value enhanced by dissolving them 
in hard cider, in the proportion of half a pound of 



REMEDIAL TREATMENT. 101 

the salts to a gallon of old cider, of which the dose 
will be two to four ounces once or twice a day. 
The object being to maintain a natural condition, 
the dose must necessarily be varied accordingly. 

Other saline laxatives may be used in their stead, 
such as Rochelle salts, seidlitz powders, citrate of 
magnesia, crab orchard salts, etc., in quantities 
sufficient to regulate the bowels. 

It so happens that women who are not plethoric 
are often troubled with constipation ; indeed, con- 
stipation is a very common condition, and is often 
a source of very great trouble. 

A Dr. Thompson, of Mississippi, author of a do- 
mestic practice, recommends a prescription which 
he calls his " Compound Syrup of Butternut or 
Anodyne Alterant," composed as follows : 



*Extract Hyoscyamus, 


J£ ounce. 


Extract Butternut, 


1% ounce. 


Extract Bi-Carbonate Soda, 


% ounce. 


Oil Sassafras, 


20 drops. 


Simple Syrup, 


1 pint. 



Mix all together, and the dose will be from one teaspoonful to 
a tablespoonful once or twice a day. 

He claims to have given it through pregnancy 
in women who had previously endured very severe 
labors on account of bearing very large children 
with the effect of contributing very greatly to the 
health of the mother, and by causing her to bear 

♦Although Dr. Thompson does not specify what form of extract 
he means, it is presumed he intends fluid extracts, as tbe solid ex- 
tracts in such proportions would be too great for the dose advised* 



102 PAINLESS CHILDBIRTH:. 

small children, securing easy and safe deliveries. 
We have never tried it under such circumstances, 
but know it to be an excellent medicine in the con- 
stipation so commonly associated with piles. 

The syrup of buckthorn, sold in nearly all drug 
stores, is a very agreeable laxative, much in use. 

Since its introduction into general use, the Gascara 

Sagrado has become deservedly popular, and we 

prescribe it with the fullest confidence that it will 

effectually relieve nearly all cases of constipation, 

whether occurring during pregnancy or at any 

other time. The formula, which I have found most 

satisfactory, is : 

Fluid Extract Cascara Sagrado, . 1 ounce. 
Tincture of Nux Vomica, . . 1 drain. 
Simple Syrup, .... 3 ounces. 

Mix and take a teaspoonf ul two or three times a day. This 
may be flavored with anything that is preferred. Those who ob- 
ject to the nux vomica may omit it. Teaspoonf ul doses of the 
fluid extract of Wahoo, or Euonymus Atropurpureus, in syrup, 
one to three times a day, answers admirably also, but is not so 
reliable in its action as a laxative as the Cascara Sagrado. 

The condition of the kidneys must always 
be remembered and any irregularity corrected. 
When the kidneys are not kept sufficiently active 
the general health suffers, and if this condition oc- 
curs about the time of delivery, it renders convul- 
sions liable. Inactivity of the kidneys is sometimes 
the cause of the swelling and dropsical condition 
of the lower extremities, though such a condition 
is usually due to pressure of the enlarged uterus 



REMEDIAL TREATMENT. 103 

upon the returning current of blood through the 

veins into general circulation. The diet we have 

recommended will usually keep both bowels and 

kidneys in a normal condition, and the squaw vine 

being diuretic is generally all that will be needed ; 

but, should the urine become scanty, the following 

may be relied upon, and will restore the kidneys to 

a healthy condition : 

Acetate of Potash, ... 1 drain. 
Fluid Extract Dwarf Elder, . . 2 drams. 
Sweet Spirits of Nitre, ... 3 drams. 
Essence Wintergreen, }£ dram. 

Water to make two ounces. 

Mix. Dose — A teaspoonf ul in water three to six times a day. 
It will, if previous instructions are obeyed, be very rare that this 
prescription will be rendered. necessary. 

There is a peculiar action going on in the uterus 
during the evolution of a new being, and some 
functions may not readily adapt themselves to the 
new order of things, and the woman is liable to a 
series of inconveniences, which, while they cannot 
be said to constitute a real disease, are very annoy- 
ing and sometimes are aggravated to such an 
extent as to endanger her welfare. Even were such 
not the case the annoyance they occasion demands 
our endeavors for their prevention and relief. 

Although the instructions already given will be 
found adequate in most cases, it so happens that 
sometimes remedial aid is necessary ; and, at the 
expense of becoming tedious, I will venture to de- 
tail the treatment I have found most successful, 



104 PAINLESS CHILDBIRTH. 

though we desire it ever borne in mind that 
hygienic influences are of the very greatest im- 
portance. 

Usually, many of the annoyances or ailments of 
pregnancy are due to causes of remote origin, the 
influences of which have continued to the present, 
impairing the vital forces, and more less seriously 
deranging those functional performances that con- 
stitute the phenomena of life. 

Morning sickness is usually an early symptom 
of pregnancy, and is the most annoying during the 
early months, generally ceasing entirely after the 
quickening. It often occurs immediately after con- 
ception has taken place, and is by many regarded 
as a very important and certain symptom of preg- 
nancy. In some cases it disappears after the first 
few weeks to reappear during the last weeks, when 
it is, no doubt, due to the pressure upon the stomach 
of the enlarged uterus. When it occurs near the 
end of a pregnancy it usually takes place after eat- 
ing. In the early stage of gestation, though the 
nausea and vomiting may occur at any hour of the 
day, it most often occurs in the morning ; and after 
it has subsided is often absent until next day. 

This unpleasant condition is rarely attended with 
much danger, though the annoyance is great, and 
it is generally presumed that it is propagated 
through the sympathetic nerves to the stomach from 
the uterus. A no less authority than the celebrated 
Caseaux claims that it depends upon some morbid 



. REMEDIAL TREATMENT. 103 

condition of the uterus, as inflammation or ulcera- 
tion, but that it is rarely fatal. It is sometimes so 
severe as to cause extreme emaciation by interfer- 
ing with nutrition, and sometimes endangers mis- 
carriage 

Singular as it may seem, well-authenticated 
cases have occurred in which the husband experi- 
enced the morning sickness instead of the wife, a 
phenomena only to be accounted for by the unex- 
plained, and perhaps, unexplainable mystery of 
"sympathy," propagated through the sexual contact. 
Some authorities have claimed that when nausea 
does not occur miscarriage is liable ; or if the full 
term is completed a difficult labor will be experi- 
enced, a claim in which I certainly cannot concur. 
While practicing in Saratoga county, N. Y., a case 
came under my observation in which the husband 
was so afflicted with nausea and vomiting that he 
was the butt of many a good-natured joke. His 
wife did not experience the slightest inconvenience 
during her " term f her labor was of but two or 
three hours' duration, easy, and she made a good 
recovery. In three successive pregnancies was this 
phenomena repeated. 

Much good may be anticipated from the dietetic 
and hygienic advice already given, for among those 
who have tried it, the absence of this annoyance 
was particularly noted. I am led to believe that 
the sickness and vomiting of pregnancy depend 
more upon those unnatural conditions developed 



106 PAINLESS CHILDBIRTH. 

by the impositions of modern social customs, than 
upon any natural relation to reproduction. 

The power of the squaw vine and blue cohosh to 
control irritable conditions of the uterus, renders 
them very effectual remedies in the nausea and 
vomiting of pregnancy, though their action on the 
stomach directly is of no consequence. When the 
sickness and vomiting occurs immediately on get- 
ting up, it may be prevented by taking the break- 
fast while lying quietly in bed. Small pieces of ice 
slowly dissolved in the mouth and swallowed, often 
have an excellent effect, and so do cold compresses 
applied over the stomach. 

When the vomiting continues through the day, 
the stomach itself is liable to become diseased and 
digestion deranged. It is well to look after the 
condition of the bowels in such cases, as constipa- 
tion is apt to be present under such circumstances. 
Bromide of Potassium, by allaying the excitement 
of the nervous system, is an efficient remedy, and 
may be used as follows : 

Bromide Potassium, ... 2 drams. 
Cinnamon Water, ... 3 ounces. 

Dose — A dessertspoonful two or three times a day. 

This will be the most appropriate in those cases 
in which there is great headache, or determination 
of blood to the head. This dose may be doubled or 
trebled, if necessary, as I have given the smallest 
dose generally employed. 

An injection of bromide of potassium into the 



REMEDIAL TREATMENT. 107 

rectum is sometimes attended with good results, 
when its administration by the stomach cannot be 
tolerated, or is of no value. Thirty to sixty grains 
dissolved in two or three ounces of liquid starch, 
thrown up at once and retained, is the proper 
amount. Dr Meigs frequently advised equal parts 
of sweetened tincture of rhubarb and the compound 
tincture of gentian, to be taken after meals ; but 
this would do little good except there was some 
primary derangement of the digestion. 

Cloths wet in laudanum or chloroform and laid 
upon the stomach are often beneficial, The mus- 
tard or capsicum plaster is worthy of a trial, as is 
also a plaster composed of various spices, applied 
over the pit of the stomach. 

When the vomiting is not prolonged, or the 
straining not severe, little attention is generally 
given it ; but when it becomes so bad as to endan- 
ger miscarriage, the most effectual means are to be 
employed. The acid fruit diet generally controls 
the sickness and arrests or prevents the vomiting, 
and for this purpose lemon juice is often valuable, 
It may be taken in doses of a tablespoonful mixed 
with an equal part of water. 

The effervescing solution of citrate of potassa, or 
magnesia is sometimes very efficacious, and acts as 
a laxative at the same time ; and being an agreea- 
ble drink, will often be tried before other means 
are resorted to. It will be in harmony with the 
principles of th§ fruit diet. 



108 PAINLESS CIIILDBIETH, 

I have used small doses of nux vomica, when 
other remedies failed, with good results, - Being a 
nervous stimulant it arouses the nervous system out 
of the condition in which reflex irritability takes 
place, and restores the lack of co-ordination that is 
present in such conditions : 

Tincture Nux Vomica, . . 20 drops. 
Water, . 4 ounces, 

Dose — A teaspoonf ul every two or three hours. 

Carbonated drinks are often valuable, the carbon- 
ic acid gas acting as a sedative upon the sentient 
extremities of the nerves supplying the stomach. 
It is upon this principle that the French remedy 
known as the potion of Riviere is beneficial. It is 
as follows : 

Citric Acid, . . . 38 grains. 

Simple Syrup, ... 3 fluid drams. 

Bi-Carbonate of Potassa, . . 36 grains. 

Yfater, 4 ounces. 

Dissolve the citric acid in half of the water and add the 
syrup. Dissolve the potassa in the remainder of the water. 
The dose is a tablespoonful of each, taken one after the other. 
It may be repeated every hour or two if necessary. 

The union of the acid and alkali in the stomach 
liberates the carbonic acid gas in the stomach and 
gets its full action there. It is very agreeable and 
efficacious. 

Prof Simpson, of Edinburg, recommends the 
oxalate of cerium, or nitrate of cerium, and in the 
hands of some practitioners they have proved 
effectual agents in doses of three to five grains, fre- 



REMEDIAL TREATMENT, 109 

quently repeated, but in their use I have been dis- 
appointed My homeopathic friends tell me if I 
would give the oxalate of cerium in grain doses of 
the second trituration, I would find it efficacious. 

Iced champagne will be found excellent in very 
many cases. 

Those of our readers who believe in homeopathic 
remedies are recommended to try aconite, nux ver- 
atrum, pulsatilla, cuprum, bromides, lobelia, ipecac, 
arsenic, in the usual doses in which homeopathic 
physicians use them. 

Dapraved appetite is also regarded by many as 
a significant sign of pregnancy. The woman may 
be siezed with a desire for some unnatural sub- 
stance, and will often eat chalk, magnesia, char- 
coal, slate-pencil, etc. They often want some article 
of food which they may have previously disliked, 
and often such articles will be found acceptable. 
When it can be done without too great an incon- 
venience this morbid appetite, or longing may 
be gratified, but when it cannot, the woman should 
dismiss it from her mind. We do not place as 
much stress upon the gratification of these unnat- 
ural appetites and desires as many, yet, as they 
afford a comfort to the mother, we suggest that 
when reasonable and practicable they may be in- 
dulged. A healthy condition of every function will 
soon do away with them, and to this end we should 
seek to improve the woman's condition by every 
possible means, rather than attempt to relieve such 



HO PAINLESS CHILDBIRTH 

desires by special means alone, The course already 
prescribed will generally soon overcome longings, 
and to give her some unexpected article of diet 
will often break the "longings." If a morbid con- 
dition exists in the stomach let it be met with ap- 
propriate remedies* Diseases of the stomach not 
belonging to this treatise must be omitted. 

If the appetite fails, let the woman abstain 
from eating for a meal or so ; or if her strength fail 
on account of it, let the appetite be " coaxed " by 
some unexpected delicacy, and small quantities of 
highly nutritious food be tried. Those who try 
our hygienic, dietetic and remedial plan will seldom 
be annoyed by loss of appetite or such morbid con- 
ditions ; but should they fail, change of climate, 
scenery or surroundings, will often work wonders 
when combined with the treatment recommended 
for morning sickness. Should they fail, it will be 
advisable to consult a physician. 

Flatulence generally comes from a. bad state of 
the digestion and is often associated with colic. 
In such cases it will be found better to eat a little, 
and often, than to eat at long intervals and much* 
at a time. Certain articles of diet will induce an 
attack, and when they are known should be 
avoided. Allowing a weak or irritable stomach to 
go long empty, and then filling it to repletion, will 
generally provoke an attack of colic if anything 
^ ill. 

^ void indigestible articles of cU et ? chevy the food 



REMEDIAL TREATMENT. HI 

thoroughly, and if remedies are needed, a grain or 
two of cayenne pepper will often relieve, or ten to 
fifteen drops of tincture of capsicum and myrrh 
(No. 6) in sweetened water. They act by increas- 
ing the power of natural digestion. A little pep- 
permint or camphor water will generally expel the 
wind and give relief. An injection to move the 
bowels will succeed. Some of these plans are gen- 
erally available and can be had on short notice, but 
as a remedy nothing can excel the following : 

Tincture of Colocynth, . . 15 drops. 
Water, 4 ounces. 

Dose — A teaspoonf ul repeated every fifteen to twenty min- 
utes during the attack, and afterwards, to break up the tendency 
of the trouble to return, a teaspoonful three or four times a day 
for several days. 

Varicose veins is the name given to the symp- 
toms where the veins of the lower extremities 
become distended, knotted and painful. They do 
not often show themselves in the first pregnancy, 
but are apt to appear later in life and become worse 
with each successive pregnancy. They are very 
much aggravated by tight garters and corsets, 
neither of which should be worn during this con- 
dition They are caused and aggravated by any 
circumstance that is capable of impeding the return 
of veinous blood from the extremities. 

A free action of the kidneys, skin and bowels has 
a tendency to relieve them, and I have seen them 
greatly benefitted by the squaw vine compound. 



112 PAINLESS CHILDBIRTH, 

Rubbing the extremities towards the body aids in 
emptying them, and is beneficial. A well-adjusted 
laced, or elastic stocking, is one of the best reme- 
dies, and can be obtained from a druggist or surgi- 
cal instrument-maker. A roller bandage,*applied 
from the toes to the body, answers the same pur- 
pose, but is difficult to apply so as to make an even 
pressure and admit of freedom of locomotion. An 
elastic perforated bandage is easily applied and re- 
tained in place. When neither of these means are 
available and the veins are troublesome, the woman 
should remain in the recumbent position as much 
as possible, or sit with the feet well elevated. An 
abdominal bandage so adjusted as to raise the 
uterus and its contents upward, and thus remove 
the pressure from the large veins as they pass 
upward through the pelvis, will also be effectual. 

Pregnant women are frequently troubled a good 
deal by the distressing symptom called heart-burn, 
for which it is customary to resort to alkalies. 
They merely neutralize the acid that is in the 
stomach, but do not arrest the causes to which it is 
due. The use of alkalies interferes with the prin- 
ciple of fruit diet and should be avoided if possible. 
Heart-burn is generally due to an impairment of 
digestion, and in too many cases to over-eating — 
the food fermenting instead of digesting. 

The proper treatment is to avoid it by abstemious 
living ; and, if it occurs, fasting — skip a meal oc- 
casionally. I have found those remedies that aid 



REMEDIAL TREATMENT^ 113 

digestion to be the most valuable in relieving it. 
Five to ten grains of pepsin just before or after a 
meal will often succeed. Charcoal will be found 
available in many cases, and is less objectionable 
than alkalies. Five grains of sub-nitrate of bis- 
muth repeated three to six times a day is an effect- 
ual remedy, I have often found acids among the 
best remedies. The following is usually a success- 
ful prescription : 

Dilute Nitro-Muriatic Acid, . % ounce. 
Water, 4 ounce3. 

Dose — A teaspoonful in a wineglassful of water after eating. 

It may be greatly aided by diminishing the quan- 
tity eaten, and also by avoiding saccharine and 
starchy food. 

Piles, a distressing complaint, is one of the fre- 
quent annoyances of gestation, and may be caused 
by prolonged constipation or anything that ob- 
structs the hemorrhoidal veins. Those women of a 
full habit are especially liable to them. Ordinarily, 
the pile tumors are small and are of little conse- 
quence beyond the annoyance they occasion; but 
when they are large, painful, and become inflamed, 
they require the services of a physician, for while 
an operation for their radical cure is seldom justi- 
fiable during pregnancy, every effort to obtain 
relief is a duty. In treatment the first point to be 
looked after is to secure and maintain a moderately 
open condition of the bowels. This may be secured 
by the fruit diet, exercise, bathing and injections. 



114 PAINLESS CHILDBIRTH. 

In the selection of purgatives it must be borne in 
mind that only the mildest kind are to be em- 
ployed. The prescription given on page one hun- 
dred and one for compound syrup of butternut is a 
good one, and I am well satisfied that the butter- 
nut has a specific action in this trouble. 

Although a very disagreeable medicine, castor 
oil is a very efficient laxative. Pills containing 
aloes, podophyllin, calomel and other drastic ca- 
thartics must be avoided, for while they have a 
tendency to aggravate the piles, they are also liable 
to produce miscarriage. After each movement of 
the bowels the parts should be well-sponged with 
cold w r ater and an ointment of galls applied ; or, 
what I prefer, a bit of linen or cotton wet in dis- 
tilled extract of Hamamelis, or witch hazel, as it is 
more commonly known. An injection of a few 
drops of this remedy into the rectum after the 
bowels have been moved will often accomplish very 
much in the way of a cure. When properly pre- 
pared it is perfectly unirritating I often have it 
taken internally at the same time, in five to fifteen 
drop doses, two or three times daily, and regard it 
as one of the best remedies we possess. The ab- 
dominal bandage, as advised for varicose veins, is 
worthy a trial, the two conditions being similar in 
pathological characters. Piles often disappear 
entirely after delivery. 

Constipation must be avoided. A daily evacu- 



REMEDIAL TREATMENT. 115 

ation of the bowels is essential to health, and to 
neglect for several days together the performance 
of so important a function is highly prejudicial, for 
if long continued it sooner or later develops a vari- 
ety of ailments often of a serious character, among 
which we may notice feverishness, loss of appetite, 
indigestion, wakefulness, headache, horrible dreams, 
sickness of the stomach, bearing down pains, piles, 
etc 

This troublesome complaint is more easily pre 
vented than cured, though a cure can almost 
always be effected Habit has very much to do 
with its development and cure The habit of 
evacuation should be encouraged daily, and the best 
time is in the morning- soon after breakfast ; the 
bowels having then been quiet during the night 
are stimulated to activity by partaking of food, and 
consequently have a natural tendency to act at this 
time, and whether the desire is felt or not the at- 
tempt should be made, which may be aided by an 
injection of tepid water.. The influence of the diet 
and exercise, which have already been recommend, 
is exceedingly beneficial in preventing and curing 
costiveness. A glass of water drank at night and 
another the first thing on rising, and an orange 
eaten before breakfast, will work wonders, Knead- 
the abdomen will aid. The use of purgatives is to 
be avoided, for while they will usually unload the 
bowels at the time, they generally impair their 
functional activity, and if often employed there is 



116 PAINLESS CHILDBIRTH* 

usually experienced a greater degree of constipation 
than before In the selection of remedies very 
much is to be considered, and when the case is se-> 
rious it is best to have competent medical advice, 
for the reason that there are several varieties of 
constipation, and the remedies that will be efficient 
in some cases will be worse than useless in others, 
and the indiscriminate employment of cathartics 
will often endanger abortion. 

Before the case has become serious, we know of 
no remedy more generally useful than the prescrip- 
tion for the Gascara Sagrado, given on page one 
hundred and two, where this subject was partially 
considered. 

Diarrhoea, looseness of the bowels, often oc- 
curs as a sequel of constipation, or in alternation 
with it. Some women are troubled with it more or 
less the entire term, while others are afflicted with 
frequent attacks, sometimes coming on without any 
assignable cause. When it occurs as a sequel of 
the constipation it is generally of a watery charac- 
ter, secreted by the lining membrane of the bowels, 
as an effort of nature to discharge the retained 
waste matter. When not severe it is salutary and 
relieves headache, heart-burn, nausea, etc., and 
usually regulates itself when the offending mate- 
rials are discharged. When, however, it is severe 
or prolonged it should receive proper attention, for 
then it weakens and predisposes to piles and abor- 
tion. 



REMEDIAL TREATMENT- 117 

Ordinarily, very little medicine need be given, 
for rest in the recumbent position and a strict diet 
will be sufficient. If there is griping and pain in 
the bowels, the tongue furred, feverishness, and the 
discharges mixed with mucus, I would advise : 

Tincture of Aconite Hoot, r , 10 drops. 

Ipecac, in tincture, . . \ . - J 10 drops, liquid or 
F ' ' (5 grains, powder. 

Water, . 4 ounces. 

Dose — A teaspoonf ul every hour or two until relieved. 

When there is a good deal of nausea and pros- 
tration the following I often find efficient : 

Fluid Extract of Veratum, * c • 5 drops. 
Water, e , j« e . 4 ounces. 

Dose — A teaspoonf ul every half hour. 

If there is a good deal of irritation of the stom- 
ach, take the following : 



Tincture of Pulsatilla, 


. 20 drops. 


Tincture of Aconite, 


. 10 drops. 


Fowler's Solution, 


5 drops. 


Water, 


4 ounces. 



Dose — A teaspoonf ul every hour or two. 

When the trouble is of a bilious character, I 
would select : 

Tincture of Nux Vomica, . .5 drops. 
Tincture of Mandrake, ... 10 drops. 
Water, ..... 4 ounces. 

Dose — A teaspoonf ul every two or three hours. 



118 PAINLESS CHILDBIRTH. 

When the diarrhoea is painless, but rather pro 
fuse, take the following : 

Tincture Cinchona, , . t dram. 

Water, ...,,., 1 ounces. 

Dose — A teaspoonf ul every three hours. 



Whenever the foregoing tinctures can be obtained 
at a homeopathic pharmacy they are to be pre- 
ferred. 

The following mixture will be found equal to al- 
most any case, having been repeatedly tested by 
myself and others, and is appropriate to a great 
variety of cases : 

Chloroform, 2 drams. 

Tincture Opium, .... 1 dram. 

Tincture Camphor, ... 2 drams. 

Tincture Rhubarb to make 2 ounces. 

Dose — One-half to one teaspoonf ul, repeated according to the 
severity of the attack, from one to four hours, until relieved. It 
may be preceded or followed by a mild dose of castor oil with 
advantage. 

A troublesome cough sometimes occurs, 

but unless it becomes so severe as to prevent sleep, 
or endanger miscarriage by the violent concussion 
of the abdomen it produces, it seldom requires at- 
tention. A teaspoonful of paregoric, occasionally 
repeated, will usually afford relief, but as I do not 
desire to use opiates when they can be avoided, be- 



''%' 



BEMEDIAL TREATMENT. 119 

fore resorting to the use of paregoric, I would try a 
teaspoonful of either of the following : 

Tincture Colinsonia, * 1 dram. 

Water, . -, . . .4 ounces. 

Mix. 

Or, 

Tincture Drosera, . ... 2 drams. 

Water, . . . . . .4 ounces. 

Mix. 

Or, 

Tincture Red Clover, . . .1 dram. 

Water, ... . 4 ounces. 

Mix. 

Or, an infusion of red clover may be drank in small quan- 
tities. 

This does not apply to diseases of the lungs, as 
consumption or bronchitis. Such diseases need 
experienced professional advice. The foregoing 
remedies however may even in these cases, 
afford decided relief. When conception occurs 
during the progress of these affections, the pul- 
monary disease is of en greatly modified, or even 
arrested, for the time, and I would under such cir- 
cumstances advise, that the very best endeavors be 
made to turn this natural effort into a perfect cure, 
by the employment of appropriate treatment, 
adapted to -the cure of the existing disease. As this 
will require careful discrimination, and the exercise 
of experienced judgment, I prefer to give advise 
adapted to each case, than to have the patient de- 
pend wholly on a generalization of plans and 



120 PAINLESS CHILDBIRTH. 

remedies that can be described in a work of this 
kind, and which does not properly form a part of 
it. Such cases are invited to write to me, as I make 
a specialty of diseases of the lungs. 

A very large proportion of pregnant women are 
troubled with headache. The causes are numer- 
ous. The influence of pregnancy upon the nerv- 
ous system contributes to the production of 
headache by inducing determination of blood, 
constipation, indigestion, and is liable to aggravate 
neuralgic, rheumatic and constitutional headache. 
We can usually do more to cure headache by at- 
tention to diet, exercise, and overcoming the causes 
that occasion it, than h$r any special remedies ad- 
dressed to the head. If it persists after the appreci- 
able causes are removed, it will be best to consult a 
physician. Those who carry out the advice already 
given in this and the two preceding chapters will 
not be troubled much with this symptom. Bromide 
of potash and ammonia in solution, as recom- 
mended for convulsions, in teaspoonful doses every 
three or four hours, will be apt to relieve these 
headaches. 

When moth and liver spots occur on the face 
they are very annoying to some. The general sup- 
position is that they cannot be removed. Painting 
them once or twice with the compound tincture of 
iodine (Lugol's solution ) will usually remove them. 
Those who would object to the color of the iodine 



REMEDIAL IHEATMENT. 121 

while it remains may fry the colorless tincture of 
iodine, Apply thoroughly. 

Some women will be troubled with intolerable 
pruritus, or itching, of the genitals and adjacent 
parts. While it is occasionally met among women 
not pregnant, it is more often an accompaniment 
of gestation. It frequently occasions the most ex- 
quisitely excruciating agony, Absolute cleanliness 
is one of the first requisites of relief — the frequent 
use of water — and to this end we can heartily 
endorse Dr. Shew's advice in regard to the use of 
the sitz bath. Maintain the most perfect cleanli- 
ness of the vagina and those structures that can be 
in any way influenced by its secretions. The sitz 
bath may be used as often as the itching returns — 
several times a day. After the bath a lotion of 
borax in water may be applied, say one ounce of 
borax to a pint, or two teaspoonfuls of aromatic 
spirits of ammonia in a glass of water, or sulphite 
of soda, one ounce to the pint, applied freely. 
These lotions may be applied successively until re- 
lief is obtained. Thus far it has been impossible 
to always select the most appropriate one without 
trial. The following lotion, after bathing, will 
often succeed when others fail : 

Chloral Hydrate, . 1 ounce. 

Hydrocyanic Acid Dilute, , . 40 drops. 
Rose Water to make 1 pint. 
Mix and apply freely. 

I have noticed in some cases acids would succeed, 



122 PAINLESS CHILDBIRTH. 

and in others alkalies, though the bath is one of 
the great remedies. When it proceeds from disease. 
of the womb that should receive proper attention. 

Inability to Sleep is particularly annoying to 
pregnant women, and should receive prompt atten- 
tion, for if long continued it may give rise to 
serious consequences. It may be due to lack of ex- 
ercise or too steady confinement in heated rooms. 
Dyspepsia is a common cause, and should be over- 
come by a well regulated diet and avoidance of late 
suppers. Tea and coffee may be reckoned among 
the causes, and should not be taken in the afternoon 
or evening by those who are apt to be wakeful. 
Reading anything exciting in the evening, writing, 
or any severe exercise of the mind, has a tendency 
to prevent sleep. Incorrect living is the underlying 
cause, and to correct it is the first step towards cure, 
and if the cause can be appreciated and understood 
we shall succeed. 

The sleeping room should be well ventilated 
and quiet ■ — neither too warm nor too cold. A 
regular hour for retiring is advisable. A glass or 
two of cold water before retiring may aid in induc- 
ing sleep, and a warm bath taken at ninety to 
ninety-six degrees just before going to bed will 
often prove a valuable remedy. A rapid sponging 
and rubbing the surface of the body has much the 
same effect. It is not advisable to take opiates, if 
possible to avoid them, and for this reason we will 
not give any recipe for them, nor for that other 



REMEDIAL TREATMENT. 123 

abused drug, chloral hydrate. When taken let 
their use be sanctioned and directed by a physician 
who can observe their effects. The remedies rec- 
ommended in the beginning of this chapter usually 
control any unnatural excitement, allay irritability 
and nervousness and produce sleep. The American 
nervine, or lady slipper, may be used with them 
with advantage, Ten to thirty drops of the fluid 
extract in the afternoon and again in the evening 
will usually promote sleep, or it may be used in in- 
fusion with the infusion of squaw vine and cohosh. 
When they fail, fifteen to twenty grains of the bro- 
mide of potash may be taken, dissolved in water, at 
a dose before retiring, or it may be added to the 
last dose of the aforesaid infusion. If preferred, it 
might be kept in a solution, thus : 

Bromide of Potassium, . . 3 drams. 
Water 3 ounces. 

Dose — A dessertspoonful to a tablespoonf ul. 

It is not best to use it when it can be avoided, as 
its long-continued use occasions more or less dis- 
turbance of the stomach. 

Painting may occur at any period of gestation, 
especially when tight-lacing is indulged in, or the 
woman has to remain long in heated rooms or bad 
air. It is especially liable to occur at "quicken- 
ing." It is to be treated the same as when it occurs 
at other times. Lay the patient in an easy posi- 
tion, the head low, and loosen the clothing ; allow 



124 painless childbirth; 

the cool air to blow in the face ; sprinkle a little 
water in the face, or have her inhale the fumes of 
ammonia, or " hartshorn/' as it is more commonly 
called. Camphor may be rubbed upon the face 
and neck, Avoid excitement or alarm. She 
should remain in a recumbent position until en- 
tirely recovered. 

Palpitation is a frequent annoyance, and is 
most liable to occur in nervous women and those 
who pay too little attention to the rules we have 
already prescribed. It is generally sympathetic, 
and it will be better to remove the cause by regu- 
lating the functions of the various organs than to 
resort to drugging for the removal of one of the 
symptoms. If it is severe and prolonged it will be 
well to have some competent physician examine 
the heart, and if necessary, prescribe. 

The same causes that operate to produce varicose 
veins may give rise to swelling of the feet and 
hands, and, in rare cases, of the whole body. The 
swelling of the extremities will usually be of 
a dropsical character, pitting upon pressure. 
Obstruction to the return current of blood through 
the veins causes an infiltration into the cellular tis- 
sues of a watery fluid, and is quite a common ail- 
ment of pregnancy. During the night, or while 
lying down, it usually diminishes considerably, to 
reappear when the extremities are again placed in 
the most dependent position. Of course it may be 
induced by diseases of the heart, liver and kidneys, 



REMEDIAL TREATMENT, 125 

but when these maladies are not present it is pretty 
safe to suppose that it depends upon pregnancy 
and will disappear entirely after delivery. It 
seldom requires any special attention further than 
what can be secured by bandaging, as advised for 
varicose veins, the recumbent position, the fruit 
diet, or the use of the squaw vine. I have seen the 
latter perform wonders, almost, in this ailment, and 
it is safe and applicable to the general aspects of 
the woman as well as to a special symptom. The 
free action of the kidneys favors relief. There are 
very many of the more vigorous diuretics which 
can be employed with benefit, but as they will be so 
rarely needed when the hygienic, dietetic and re- 
medial measures already prescribed are employed, 
that I will leave their employment, should neces- 
sity for them arise, to a physician who sees the case. 
For my own part, I have found the directions I 
have given already to be equal to the necessity, 
even if they are simple. 

Pressure of the pregnant uterus on the sacral 
nerves is liable to occasion cramps in the lower 
extremities. Some women are very much annoyed 
by them. Change of position in lying down • turn 
frequently from one side to the other, so that the 
pressure shall not be too long continued upon those 
nerves that are distributed to one or the other ex- 
tremity ; avoid lying on the back long at a time, as 
that position is most apt to bring pressure upon the 
large blood vessels and plexuses of nerves. Fre- 



126 PAINLESS CHILDBIRTH. 

quent changes and brisk friction with the hand are 
better than drugs. A properly constructed abdom- 
inal bandage so arranged as to support the enlarged 
abdomen, and rather lift it by straps from the 
shoulders, will often put an end to this disagreeable 
symptom. 

Some women are habitually liable to mis- 
carriage when they reach a certain stage of gesta- 
tion, and a woman who has been once the subject 
of this accident is much more liable to a repetition 
of the occurrence than one who has not. In early 
married life the idea often obtains that children are 
not desirable, for some reason or other, and not 
succeeding in preventing conception, a worse crime 
is resorted to. How many women have found to 
their sorrow that the damage they then do lays the 
foundation for a miscarriage at every succeeding 
pregnancy. For this reason alone hundreds of 
homes are lonely and desolate. 

When once a woman has miscarried, there is a 
disposition to do so again, when the same stage of 
gestation has been reached, and the more times she 
miscarries the stronger the disposition to do so be- 
comes. Many have resorted to foeticide in early 
life to avoid maternal responsibilities, only to find 
by and by, when children are desired, that they can- 
not have them, either because they are lost by miscar- 
riage in spite of precautions, or else the shock their 
reproductive organs have sustained by the previous 



REMEDIAL TREATMENT. 127 

abortions has left them no longer capable of con- 
ception. 

There are few subjects of greater importance to 
society than this, and I might exceed the entire 
space of this volume with its consideration. 
Whether accidental or intentional, there are few, 
if any, accidents that can befall a pregnant 
woman of a more serious character than 
miscarriage. And while it was not my intention 
to discuss the question in its social or moral aspect, 
yet when we consider that the great mass of women 
are debarred from familiarity with those means by 
which they can limit their offspring by the prohib- 
itory laws of the country, we can the more readily 
comprehend the incentive to the greater crime. 
Legally deprived of the one means they resort to 
the other, and I question whether this law is not the 
cause of infinitely more harm than good. It is to 
be regretted that it is so, but facts are stubborn ar- 
guments. Prevention of conception may be mor- 
ally, socially and physiologically justifiable, but the 
crime of abortion never ! 

With the following quotation, from Dr. Naphey's 
Physical Life of Woman, I shall close the moral con- 
sideration of this unpleasant subject : 

From the moment of conception a new life commences ; a new 
individual exists; another child is added to the family. The 
mother who deliberately sets about to destroy this life, either by 
want of care, by taking drugs or by using instruments, commits 
as great a crime, is just as guilty, as if she strangled her new- 
born infant, or as if she snatched from her own breast her six- 



128 PAINLESS CHILDBIRTH. 

months darling and dashed out its brains against the wall. Its 
blood is upon her head, and as sure as there is a God and judg- 
ment that blood will be required of her. The crime she commits 
is murder — child-murder — the slaughter of a speechless, help- 
less being, whom it is her duty, beyond all things else, to cherish 
and preserve. 

The crime is common ; it is fearfully prevalent. Hundreds of 
persons are devoted to its perpetration ; it is their trade ; in nearly 
every village its ministers stretch out their bloody hands to lead 
the weak woman to suffering, remorse and death. Those who 
submit to their treatment are not generally unmarried women 
who have lost their virtue, but the mothers of families, respect- 
able Christian matrons, members of churches, and walking in 
the better classes of society. 

We appeal to all such with earnest and with threatening words. 
If they have no feeling for the fruit of the womb, if maternal 
sentiment is so callous in their breasts, let them know that such 
produced abortions are the constant cause of violent and dan- 
gerous womb diseases and frequently of early death; that they 
bring on mental weakness and often insanity ; that they are the 
most certain means to destroy domestic happiness which can be 
adopted, Better, far better, to bear a child every year for twenty 
years than to resort to such a wicked and injurious step ; better 
to die, if needs be, in the pangs of childbirth than to live with 
such a weight of sin on the conscience. 

Physicians are united in saying that the crime of 
abortion is more prevalent among the better classes 
of society, who have ample means to provide for the 
increase, than among thoFe to whom each additional 
child adds an extra tax and often a serious burden. 
There is no reason to dwell upon this subject here, 
but the time is approaching when those who have 
the welfare of the race at heart must choose between 
two evils — prevention of conception on the one hand, 
and murder on the other. The physical damage 



REMEDIAL TREATMENT, 129 

done to woman, the moral and social damage to 
society, will demand consideration when the u pop- 
ulation " question is forced upon us, if not before. 

There are numerous causes of miscarriage. 

Some miscarry at a certain time without any as- 
signable cause. Any violent exertion, anything 
that occasions a shock, or spasmodic action of the 
abdominal muscles, the irritation of piles, excessive 
sexual indulgence, a blow, a fall, violent emotion, 
nursing, riding over rough roads, abuse of cathar- 
tics, disease and displacement of the womb, affec- 
tions of the ovaries, the occurrence of fevers and 
eruptive diseases, excessive vomiting, weakness, 
plethora — any excitement that is- capable of ex- 
citing contraction of the uterus is liable to 
terminate in miscarriage. The occurrence of this 
accident in the first pregnancy is very apt to estab- 
lish the habit. Women who marry late are more 
prone to miscarry than if they marry earlier in 
life. 

The symptoms of miscarriage are rather 
variable, of longer or shorter duration, from a few 
hours to several days, and the consequences are 
equally various. At first there is uneasiness, lan- 
guor, weakness, with aching pain in the back, more 
or less severe. These may be regarded as the pre- 
liminary symptoms, and after they have continued 
for some time, symptoms of labor supervene and 
resemble the labor at full term, and are in very 
many cases much more prolonged and more severe. # 



130 PATHLESS CRILDBTBTir. 

The mouth of the womb, for physiological reasons, 
is not as readily dilated as at the full term ; and in 
consequence, more prolonged efforts are usually 
necessary and greater suffering experienced, and 
inflammations more apt to follow. 

In the beginning of the active stage of miscar- 
riage the pains are slight, short, and recur at long 
intervals. As the process goes on they last longer 
and are more frequent and severe. A discharge of 
blood or mucus may be observed, and as it pro- 
ceeds, there is pain in the back, extending around 
the loins into the abdomen and perhaps down the 
thighs, increasing in regularity, frequency and 
force. The pulse is quickened, the skin hot, the 
patient makes voluntary expulsive efforts to aid the 
contractions of the womb, and ultimately the con- 
tents of the uterus are expelled. 

Sometimes the foetus will be expelled with little 
pain, scarcely any hemorrhage, and a quick recov- 
ery. In other cases it may come on with hemor- 
rhage, and after a protracted and painful labor the 
foetus will be expelled. The placenta, or afterbirth, 
may remain, and may not come away until it has 
been dissolved and thrown off with the discharge 
that follows, and will be very offensive. So long as 
the placenta, or any part of it remains, hemor- 
rhage is to be feared and irritation or fever 
liable. 

Preceding, accompanying, and sometimes follow- 
ing the miscarriage, there may be alarming hemor- 



REMEDIAL TREATMENT. 131 

rhage. It may be internal or external When 
external the patient and friends may be deceived 
until a fatal termination is the result. When in- 
ternal the patient gets pale and faint, exhausted ; 
the pulse becomes quick and thread-like ; there 
will be headache, shivering, pain ; the abdominal 
cavity fills up and becomes larger than the stage 
of pregnancy will warrant; after a time the mem- 
branes give away, the flood-gates of life are opened 
and the vital current escapes with a gush. The 
woman may die from internal hemorrhage without 
its escape. The more nearly the woman has ap- 
proached the natural term for delivery the less the 
danger. Ordinarily the hemorrhage consti- 
tutes the primary danger, and it usually can- 
not be perfectly and permanently controlled after 
the progress of the labor has well advanced until 
the contents of the womb are expelled and the 
organ has contracted. The hemorrhage is some- 
times alarming, profuse, fatal. 

Well do I remember my first case. I was not the 
family physician, but he had been sent for — he 
had not come — the hemorrhage was alarming — 
my youth was the objection, but something must be 
done — the danger was imminent — I was called—- 1 
found the patient pulseless, blind, deaf, and as white 
as the sheets upon which she lay, Soaking through 
the bed, from which several vessels of coagulated 
blood had been removed, dripped the sanguine tide 
until it had run across the room and was dammed 



132 PAINLESS CHILDBIRTH. 

in a large pool in the corner. Without waiting to 
deliberate or question — and, I confess, without a 
ghost of hope — I put ten grains of gallic acid in a 
tablespoon and, filling it with whisky, forced 
apart her rigid jaws and poured it into her mouth 
— she swallowed — I hold the wrist — ten minutes 
of agony — a teaspoonful of fluid extract of ergot 
in whisky — the hemorrhage is slackening — per- 
haps the supply is exhausted, but I can^feel a thrill 
at the wrist ! I repeat the gallic acid and whisky 
and the womb contracts — the foetus is expelled — 
there is no hemorrhage — it is arrested and the 
woman saved I The family physician arrives and 
gladly I turn over the cases ; and whether my 
practice is scientific or not, whether nature or med- 
icine is deserving of credit, I get the praise of hav- 
ing saved a life that a moment before was hovering 
on the brink of eternity ! 

In the management of miscarriage three in- 
dications present themselves, from which a selection 
is to be made : 

First, to prevent its occurring if possible. 

Second, to arrest it. 

Third, to carry the patient safely through the 
process, provided it cannot be prevented or averted. 

If aware that a patient is in the habit of abort- 
ing I should advise the hygiene and diet already 
recommended, together with the squaw vine and 
blue cohosh already considered, to which we would 



REMEDIAL TREATMENT. 133 

advise the same amount of Viburnum, or, as it is 
vulgarly known, cramp bark This, with perfect rest 
in the recumbent position, absolute quiet, a calm, 
unruffled mind, unstimulating food, and the avoid- 
ance of sexual relations are the essentials of success. 

If we can carry the patient past the fifth month 
we shall generally succeed. For drugs, the three 
mentioned cannot be excelled. Regulate the 
bowels with some of the means already mentioned, 
and if the irritability of the uterus continues, we 
must resort to opium — a grain in powder or pill 
every four hours until all pain is relieved, to be re- 
peated if it recurs. The action of the opium is as 
positive as anything can be, and if the symptoms 
are active, alternate it with the fluid extract or 
strong infusion of the cramp bark. This is, as its 
name implies, a potent remedy, and has stood the 
test of years. It may be given freely. It is said 
that the planters of the South formerly compelled 
their pregnant slave women to drink an infusion 
of it in order to frustrate their attempts at abortion. 

Should our efforts fail in preventing the miscar- 
riage it must be managed like a case of labor (which 
see ). Hemorrhage being the greatest danger, 
if it becomes too free I would give five grains of 
gallic acid in a wine glass of cinnamon water, and 
repeat as often as may be necessary ; or, if cinna- 
mon water or tea is not at hand I would not wait, 
but use plain water. Cinnamon is, however, valu- 
able of itself. Ten drops of oil of erigeron on 



134 PAINLESS CHILDBIRTH. 

sugar may be given in its place, or even ten drops 
of fluid extract of Cannabis Indica. 

Care must be taken to assure the entire removal 
of the secundines. There will be danger until 
everything " has come away." 

If we can ascertain the cause of abortion we can 
usually overcome it, or remove the patient from the 
sphere of its operation. 

It is not expected that the unprofessional reader 
is going to rely implicitly upon the directions we 
have given. In cases that are alarming or trouble- 
some a physician must be called — one who can 
determine the questions that may present obstacles 
to others. Our wish is to furnish means of preven- 
tion and aid the physician in arresting or conduct- 
ing the process of miscarriage. 

Among the results to the mother, other than 
death, from either accidental or artificial miscar- 
riage, are the whole train of ailments of the 
reproductive organs of woman. Displacements, 
inflammations, ulcerations, deformities, ovarian 
disorders, leucorrhcea, irritation of the bladder, bar- 
renness, mental disturbance, general ailments, etc. 

Although many women are subject to these dis- 
eases who do not miscarry, it is nevertheless true 
that they are the bane of woman's existence. They 
are often regarded as incurable, and under the old 
regime they generally w T ere, but in the light of a 
proper understanding of the principles of these ail- 
ments, and the remedies at our command I have 



mMEDIAL TREATMENT. 135 

been able to cure many after they had been pro- 
nounced incurable by others. 

Abhoring the harsh treatment of the past, it will 
doubtless be a source of comfort to many an afflicted 
lady to know, that, by properly considering the 
constitution, the disease, and its complications, we 
can generally send medicines to use at their homes 
that will restore them to health.* Symptoms are 
the language of diseases* and for the most part are 
intelligible. Knowing this it will place a cure at the 
disposal of thousands who could not travel hun- 
dreds of miles to consult the physician of their 
choice. 

Although this may appear incomprehensible to 
some, and be opposed by those specialists who can 
do nothing without the " speculum and caustic," it 
is none the less true, that, applying these principles 
to practice, I am constantly curing patients whom 
I have never seen, many miles away. 

Those who are subject to nervousness know 
what it is without any special description. The 
nervous system is impaired, irritable, and though 
there may not be any pain, the sensation is even 
worse ; no position seems the proper one ; a gen- 
eral uneasiness prevails without nausea ; no special 
organ appears to blame, and yet in the majority of 
cases there is a general impairment of function. 
We can accomplish much in improving the general 
condition by the dietetic and hygienic means 
already laid down ; but the peculiar nervousness 



136 PAINLESS CHILDBIRTH. 

will, in many cases, demand special prescriptions. 
Do not resort to opiates, or Dover's powders, mor- 
phine, nor chloral hydrate, lest you become habit- 
uated to their use. When these drugs are used it 
should be under the supervision of a competent 
physician. The squaw vine and blue cohosh are 
excellent to allay nervousness, and when it con- 
tinues in spite of them, I would add to them the 
lady slipper, or American nervine, in the propor- 
tion of one ounce of the root to a pint of the infu- 
sion ; or, when the squaw vine infusion is drank 
freely, one-half ounce will be sufficient. Under its 
use quiet sleep is encouraged, and a general im- 
provement is induced. A pill of asafoetida is good, 
and may be taken if the other does not succeed. 
When these remedies are employed it is seldom, 
indeed, that narcotics will be required. 

Some women suffer untold torture from sore 
nipples during the period of nursing, and occa- 
sionally before delivery. When such is the case, it 
is advisable for two or three months before delivery 
to institute a course of training, and gradually 
harden or " toughen " them. For this purpose an 
ointment may be made of the squaw vine, as has 
already been mentioned, or some astringent lotion 
may be employed. The application of tincture of 
myrrh twice a day for six or eight weeks before de- 
livery will usually succeed. Equal parts of tinctures 
of myrrh and golden seal cannot be surpassed. At 
the same time rub the nipples between the thumb 



REMEDIAL TREATMENT. 137 

and finger, not, however, severely enough to make 
them sore. A solution of alum is good. 

It is always best to harden them before confine- 
ment, as after the child has begun to nurse it is 
exceedingly difficult to cure them, and they often 
become deeply fissured and extremely painful. In 
such cases borax is of great value. Take one or 
two drams of borax, one ounce of glycerine and 
three ounces of rose water ; mix and apply several 
times a day. Tanin in a little water with a little 
glycerine is a useful remedy, either before or after 
childbirth, in the proportion of ten to thirty grains 
to the ounce. 

In fissures, the application of collodion forms a 
perfect protection from irritation, and should be 
applied often enough so that it does not get removed. 
Under its protection an exceedingly tender nipple 
will heal and become healthy. It forms a more 
perfect protection than the rubber nipple. It can 
be got at all drug stores prepared ready for use. 
Its contraction in drying, is sometimes so great as 
to cause pain, but this objection may be obviated 
by the addition of a small quantity of Venice tur- 
pentine, with which fact all druggists are familiar 
and can supply it properly prepared. In applying 
it, of course, there must be an opening in the coat- 
ing of collodion, at the point of the nipple, through 
which the milk may flow. Any druggist will ex- 
plain the manner of application. A rubber shield 
or a glass nipple with rubber tube, such as are sold 



138 PAINLESS CHILDBIRTH 

at drug stores, may be used if the soreness is so 
great she can not bear the pain caused by the child 
nursing. 

Leucorrhoea, an exceedingly prevalent affec- 
tion, is usually due to the existence of some disease 
of the uterus, or vagina, of which it is a symptom. 
When it has existed prior to conception it is very 
apt to continue, and often gives rise to very great 
annoyance from the debility, soreness or irritation 
it causes. 

The treatment will be essentially the same as 
when it occurs in those who are not pregnant, 
though instrumental treatment will be inadmissi- 
ble. Absolute cleanliness is essential ; the sitz bath 
is excellent. The decomposition of the perverted 
secretions gives rise to irritation and must be over- 
come by ablutions, injections, etc. 

Injections may be made of tepid water or soap 
suds, or they may be medicated. They should be 
used daily, or oftener, to be of any use, and no force 
should be permitted. An infusion of white pond- 
lily root is an injection in which many have great 
confidence. Carbolic acid, five grains to a pint of 
water used at a sitting, is an excellent disinfectant 
and exerts a control over the abnormal discharge. 
Common soda, a teaspoonful in a pint of water is 
good ; astringents in the form of infusions may be 
used. Hemlock bark, oak bark, golden seal root, 
crane's bill, are all applicable, but should not be 
used too strong. As a rule, an ounce or less to a 



REMEDIAL TREATMENT. 139 

pint of hot water, standing till cold and used after 
the proper steps to secure cleanliness, will be about 
the strength adapted to the majority of cases. 

The remedies advised in the beginning of this 
chapter are of great advantage in this complaint, 
and the tincture of pulsatilla, in doses of two or 
three drops three times a day in addition to the 
foregoing, is a good remedy. It can be procured at 
any well regulated drug store, especially where 
homeopathic remedies are kept. 

The list of remedies for this complaint could be 
greatly enlarged, but as some of them might have 
a tendency to cause miscarriage, I have purposely 
avoided them. The discharge being a symptom of 
disease of some portion or portions of the repro- 
ductive organs, the proper time to pay the most 
attention to its cure is when the delivery has passed ; 
hence, simple means only are recommended, first 
and foremost of which is cleanliness. 

Neuralgic, or rheumatic pains are liable to 
occur at any stage of gestation, and are often very 
annoying. They can be distinguished from true 
labor pains, which they stimulate, by placing the 
hand upon the abdomen. In true pains the uterus 
can be felt to contract and harden with the occur- 
rence of the pain, but if it is a false pain no such 
sign will be noticed. They are often associated with 
colic (which see). If they become too troublesome 
a physician had better be consulted, as he can best 
understand their origin, and by removing the cause 



140 PAINLESS CHILDBIRTH. 

overcome the effect. We do not apprehend that 
many of our readers will be troubled with them if 
they carry out the measures already described. 

Many women suffer during the entire term of 
pregnancy from an irritable condition of the 
bladder, compelling them, to urinate every few 
minutes, passing a few drops at a time, with pain 
and burning. 

In the early months it may be due to mechani- 
cal irritation from pressure of a displaced uterus 
against the neck of the bladder, and later on from 
pressure upon the body of this organ. In numer- 
ous other instances, however, it cannot be attributed 
to any such mechanical cause, but is due to some 
abnormal condition of the bladder itself. Usually, 
the urine is not increased in quantity, but rather 
diminished, and often scalding. 

The measures already advised in the chapter on 
hygiene and diet will usually prevent this trouble, 
or the employment of the squaw vine will over- 
come it, but occasionally a case may resist these 
means. I would then advise : 

Fluid Extract Gelseminum, . . 15 drops. 
Fluid Extract Populus, ... 1 dram. 
Water, 2 ounces. 

A teaspoonful every two or three hours till relieved, to be 
renewed if the trouble occurs again. 

I have also found the homeopathic remedies, can- 
tharis or apis, to relieve this condition. I have 
employed them by putting five drops of the mother 



REMEDIAL TREATMENT. 



141 



tincture in half a glass of cold water and giving a 
teaspoonful every hour until relieved. As soon as 
relieved stop taking them. A tea made of couch 
grass, drank freely, is a very efficient remedy for 
this complaint. 

It is not best to rely on unprofessional advice in 
case of convulsions, though until the physician 
arrives the following may be given in teaspoonful 
doses every half hour, or hour : 



Bromide of Potash, 
Bromide of Ammonia, 
Water 



1 dram. 
1 dram. 
1 ounce. 



Mix. 



A host of remedies have been tried in this ail- 
ment and many plans advised, but as professional 
aid must be employed, we do not think it best to 
advise, particularly as it does not come within the 
scope of a popular work. 



142 PAINLESS CHILDBIRTH. 



CHAPTER VIII. 



ANAESTHETICS. 

A Priceless Boon and Perfectly Safe — Accidents Among Dentists 
— Theoretical Objections not Sustained in Practice— The 
Degree of Insensibility Desired — Should Other Plans Fail, 
this will make Labor Painless — Who Shall Take Them and 
Who Shall Not — How Long Continued — Views of Physi- 
cians — Why this Chapter is Introduced. 

The discovery of anaesthesia wrought an im- 
portant change in the practice of surgery and con- 
ferred a priceless boon upon mankind. The power 
of anaesthetics, of which ether and chloroform are 
the most important and frequently used, to suspend 
the sensibility without at the same time destroying 
life, is indeed wonderful. With them we are en- 
abled to so effectually subdue pain that under their 
influence the most painful surgical operations can 
be performed without the knowledge of the subject. 
They produce absolute insensibility to pain. Much 
has been said regarding the safety of their employ- 
ment, and although we admit there is a danger, it 
is very seldom that the person to be operated upon 
chooses the pain of the operation in preference to 
the danger of the anaesthetic. 

The question of danger, however, is scarcely 



ANESTHETICS. 143 

worthy of a consideration when we take into account 
the frequency of anaesthetic administration and the 
very few accidents resulting therefrom. We hear 
of more accidents occurring among dentists than 
anywhere else. Unfortunate as such circumstances 
are, it is really no reflection upon the importance, 
or, if you please, the safety of anaesthetics. 

The reasons why accidents occur more frequently 
among dentists are plain. There can be no doubt 
but that the sitting position is more unfavorable 
than the horizontal, a circumstance that requires no 
extended argument here. Dentists are not supposed 
to be so well acquainted with physiology and pathol- 
ogy that they can select their cases with the skill 
surgeons do. Again, they do not usually possess, 
or understand the employment of restoratives as 
well as physicians. Also, we must remember the 
frequency of administration in dental offices. 

Wo only hear of the accidents; and though a 
dentist may administer anaesthetics in thousands of 
cases with no unfavorable result, should the next 
case prove fatal it is heralded to the world, and 
either the dentist or the anaesthetic condemned. 

I do not wish to be understood as attempting to 
defend the dental profession, for they are doubtless 
capable of making their own defense ; but I desire 
to show that even under such circumstances as they 
are compelled to employ these agents, the percent- 
age of danger is very small indeed. As near as can 
be ascertained but one case proves fatal in twelve 



144 PAINLESS CIULDBIRTIL 

thousand administrations, a fact that reduces the 
risk to such an extent that when proper precautions 
are taken to insure safety, no one need have any 
fear. 

I have during my life been present at the admin- 
istration of chloroform or ether in several hundred 
cases, and have never yet seen a person die from 
anaesthesia. Daring the late war I had an oppor- 
tunity for one year (spent in a large hospital) of see- 
ing them used very often, and have since used them 
in my own practice to considerable extent, and ob- 
served their use by others, and in all I can recall 
but two instances in which any trouble occurred, 
and in those resuscitation was easily effected with 
the battery, artificial respiration, stimulants, etc. 

Surgeons who have had very extensive experience 
with these agents assure us of similarly safe results. 

While it may be impossible to determine an exact 
relation of the number of accidents to the number 
of anaesthetic administrations from experence 
gained in hospitals and armies, we are able to arrive 
at approximate results. Some who have collected 
Statistics find a much greater mortality than others. 

In Wood's Library of Standard Medical Authors 
on Anaesthesia, by Prof. Lyman, of Chicago, we find 
the following collection : 

Andrews, of Chicago, collected statistics of 92,815 cases of 
etherization, including 4 deaths, or 1 in 23,204; 117,078 cases of 
chloroform anaesthesia with 43 deaths, or 1 in 2,723. Dr. Coles, 
of Virginia, collected 152,620 cases of chloroform inhalations 



ANESTHETICS. 145 

with 53 deaths, or 1 in 2,873. Richardson's inquiries in the prom- 
inent hospitals of England resulted in the collection of 35,165 
cases of inhalation by chloroform with 11 deaths, or 1 in 3,196. 

Ker (Chisholm : < Yvnat anaesthetic shall we use ?') states that 
during the 23 years from the time of the introduction of chloro- 
form there were only 2 deaths caused by its use in the Royal In- 
firmary in Edinburgh. During the last ten years of that period 
he estimates that there were 33,500 cases of chloroform anaes- 
thesia with only 1 death. Elser, of Strasburg, had used chloro- 
form 16,000 times without a fatal case. Kidd, of London, had 
seen it administered upwards of 10,000 times and had seen no 
fatal ease. Richardson had seen it used in the London hospitals 
15,000 times before he met the first fatal case. Clover has re- 
corded 3,000 administrations without a single death. Billroth, 
of Vienna, had given chloroform 12,500 times before he met 
his first accident. McGktire, surgeon to Jackson's corps of the 
Confederate army, reported 18,000 administrations without one 
death. Chisholm himself used chloroform 6,000 times without 
a death. His estimate of the mortality from the use of chloro- 
form was 1 in 20,000. 

During the war of the rebellion, 1861-65 (circular No. 6, p. 87), 
chloroform was given in 80,000 cases with 7 deaths, or 1 in 11,448. 

Prof. Lyman gives numerous other observations 
of various surgeons, which he sums up thus : 

Ether, 99,255 inhalations, 6 deaths, .... 1 : 16,542 
Chloroform, 492,235 inhalations, 84 deaths, . 1 : 5,850 

The result of his investigation show3 a much 
greater mortality observed by some than others, but 
there is nothing shown to which to attribute the 
difference in the mortality. In such an extensive 
employment of anaesthetics it is but fair to suppose 
that, in many instances, it became necessary to ad- 
minister it in cases in which contra indications for 
its use existed. In many of the fatal cases, no 



146 PAINLESS CIIILDBlRTn. 

doubt the disease or injury that necessitated the 
employment of the anaesthetic was more to blame 
for the death than the anaesthetic itself. 

If anaesthetics may be used to prevent pain in 
surgical operations, the question very naturally 
arises : Why may they not be equally appropriate 
for the prevention of pain at childbirth ? 

Various objections to their employment 
have been urged, the principal one of which is, that 
when the patient is under the anaesthetic influence 
the uterine contractions are suspended and the 
labor arrested. Theoretically this objection appears 
plausible enough, but it is not sustained by practice. 

Obstetricians who have made this question the 
subject of special study, assure us of the safety of 
anaesthesia properly managed, and that suspension 
of uterine contraction under their use is the excep- 
tion instead of the rule. I have myself repeatedly 
administered chloroform in parturition, and instead 
of prolonging the labor I have every reason to be- 
lieve that it was materially shortened. Under the 
influence of the drug the irritability of the nervous 
system was diminished, and those wearing, cutting, 
irregular and inharmonious pains that so often pre- 
vail and cause so much suffering and annoyance 
were suspended, and instead of expending the ener- 
gies of the woman the natural pains become more 
regular and efficacious. 

In administering the anaesthetic I endeavor 
to secure, as near as possible, that state of semi-un- 



ANESTHETICS. 147 

consciousness in which the sensation of pain is 
nearly or quite suspended, without inducing that 
profound anaesthesia that interrupts all muscular 
action. A good way to accomplish this is to render 
the inhalation intermittent, to correspond as near 
as may be with the occurrence of the pains, renew- 
ing the inhalation at the commencement and with- 
holding it during the interval. By this method the 
objections urged by many against the use of chlo- 
roform in parturition are obviated. We do not sus- 
pend natural contractions, although we afford the 
necessary relief without any danger of charging 
the blood to the extent of endangering the life of 
the child. 

I do not wish to be understood that anaesthetics 
cannot suspend labor ; such a position would be ex- 
tremely ridiculous, for it is known that anaesthesia 
may be so profound that all involuntary action may 
be suspended, the heart and respiration cease and 
death result ; but I do assert that when the anaes- 
thetic is employed to induce partial insensibility 
that uterine contraction will not be impaired. I am 
well convinced that the realization of pain will cease 
under the administration of an anaesthetic before 
muscular contraction is suspended, and I know from 
clinical experience that the administration of chlo- 
roform or ether may be so managed as to overcome 
pain and not prolong labor, and that if all other 
means were to prove fruitless, with these agents we 

HAY MAKE CHILDBIRTH ABSOLUTELY PAINLESS. 



148 PAINLESS CHILDBIRTH. 

Fow, indeed, are the accidents that are known to 
have occurred from the use of chloroform in child- 
birth, and the use of anaesthetics in midwifery prac- 
tice is justly deemed the least dangerous occasion 
for their employment. Yarious theories have been 
advanced to account for this fact, the most plausible 
of which, to my mind, is that the partial degree of 
anaesthesia necessary for the purpose cannot be as 
dangerous as the profound insensibility necessary in 
surgical operations. There is no need to discuss the 
other theories in this work. The facts that labor 
can be rendered painless by such means, even when 
every other plan has failed, and that the danger is 
trivial, are of far more consequence to the woman. 

I am supported in my belief by the experi- 
ence and observation of such men as Sir James 
Y. Simpson, Dr. Tilt, Dr. W. P. Johnston, H. E. 
Storer,Dr. Beatty and others, that when there is not 
some valid reason for withholding it, the proper 
employment of anaesthesia is far less harmful than 
the suffering that too often occurs at such time. 

When the patient is healthy and robust, the suf- 
fering inconsiderable and the labor promising to be 
short, I should certainly refuse to give the anaesthetic, 
simply because there would be no necessity for its 
administration ; but in a weak and feeble woman, 
suffering intensely, her pain torturing her to no 
effect, the suffering endangering exhaustion, I would 
not hesitate for a moment ; I would administer the 
agent in confident expectation of relieving her 



4XJB3TSETI08. 149 

agony, preventing prostration, regulating the uterine 
contractions and shortening the labor. 

It is a popular supposition that in feeble, anae- 
mic, nervous and delicate persons the anaesthesia is 
specially dangerous, but this is a great mistake ; as 
a rule, such persons bear it best. Organic disease of 
the heart and lungs constitute the principal valid 
objections to the employment of these agents, and 
even when they exist I am inclined to question 
whether the danger is not greater without them. 
Certain it is that anaesthetics have been administered 
to patients suffering from organic diseases of those 
organs, when important surgical operations have 
been necessary, with recovery. 

While he practiced midwifery, Dr. H. R Storer, 
w T ho is considered good authority, made it his rule 
to always administer chloroform to parturient pa- 
tients, and this no matter whether the labor was a 
rapid one or not, or whether the patient had, or had 
not, organic disease of the heart or lungs, believ- 
ing, as he did, that not only was it the physician's 
duty to relieve pain, here ordinarily so exquisite, 
and to lessen the risk to both mother and child, as 
was done by the relaxation of the voluntary mus- 
cles effected by the anaesthetic, but that for certain 
manifest reasons chloroform was preferable to ether 
for obstetric use. 

It may be urged that to be of utility in midwifery 
the patient will have to be kept under the anaesthetic 
influence for so long a time that it will add to the 



150 PAINLESS CHILDBIRTH. 

danger and thus render it objectionable. While I 
would not advise the continuance of the anaesthetic 
any longer than is necessary, it is well known that 
in certain surgical operations it is necessary to keep 
the patient under its influence for several hours to- 
gether. I have myself kept a patient under the in- 
fluence of chloroform for several consecutive hours, 
during which time it was not allowed to pass off so 
that complete consciousness returned, and, I am 
glad to add, no untoward results followed. 

A physician of my acquaintance tells me that h# 
once kept a parturient patient under the influence of 
an anaesthetic for sixteen hours without intermission, 
and with the happiest consequences. Sir J. Y. 
Simpson mentions a case in which a child was kept 
under it until one hundred ounces of chloroform 
had been used, or about seventy-six hours, and that 
the convulsions for which it was given were thor- 
oughly subdued by it. 

Probably Professor Simpson has done more to 
prove the value of chloroform in obstetrical 
practice than any other man. His practice has 
been extensive and opportunities for observation 
unsurpassed. He employed it in thousands of cases, 
both in hospital and private practice, and the con- 
clusions he arrived at are that it is entirely safe 
and beneficial. 

Dr. Tilt says : 

In our own time the sting has been taken from the curse (of 
pain) by the discovery of chloroform, for which one of our 



ANESTHETICS. 151 

greatest men will ever rank next to, if not before, the discoverer 
of vaccination. 

Dr. Beatty, a well-known author, in some of his 
writings speaks of it in the most enthusiastic man- 
ner, and says : 

When its employment is properly conducted, it is not attended 
with any injurious effects upon either mother or child. 

In another, and a later paper, he says : 

I have continued to use chloroform with the happiest results. 
I have not pressed it upon any, and rejoice, at the end of two 
years' additional experience, to be able to state that in all cases 
its use has been productive of the greatest relief and happiness, 
and that in no case has anything unpleasant occurred to either 
mother or child during its administration, or subsequent to deliv- 
ery. It will be easily imagined that my confidence in the power 
of the agent has increased with my experience. 

In the Physical Life of Woman, Naphey says : 

Is it possible to avoid the throes of labor, and have children 
without suffering ? This is a question which science answers in 
the affirmative. Medical art brings the waters of Lethe to the 
bedside of woman in her hour of trial. Of late years chloro- 
from and ether have been employed to lessen or annul the pains 
of childbirth with the same success that has attended their use 
in surgery. Their administration is never pushed so as to pro- 
duce complete unconsciousness unless some operation is neces- 
sary, but merely so as to diminish sensibility and render the pains 
endurable. These agents are thus given without injury to the 
child, and without retarding the labor or exposing the mother to 
any danger. When properly employed they induce refreshing 
sleep, revive the drooping nervous system and expedite delivery. 

I might fill the balance of this volume with quo- 
tations from the opinions of physicians in favor 
of anaesthesia, but it would not be of any practical 
value to the woman who is about to become a mother 



152 PAINLESS CHILDBIRTH 

without a practical demonstration of its efficiency 
Statements alone will not render her sufferings any 
less. 

The author does not for a moment suppose that any 
unprofessional person will ever undertake admin- 
istration of an anesthetic. The educated phy- 
sician alone is competent to give it with safety, 
and he must be provided with a pure article and 
attentively watch its progress. The patient must 
be in the recumbent position at the time and the 
stomach empty, or nearly so, and the drug is to be 
inhaled along with plenty of atmospheric air. 

Curious and critical persons may inquire 
why this chapter is introduced into this work if the 
directions laid down in the three preceding chapters 
are of any practical value. They may say that any 
preparation is unnecessary when chloroform and 
ether furnish so reliable and easy an escape from 
pain. 

In reply, I have only to say that I have not writ- 
ten this little work with a view to advocate any 
particular method of proceedure, or remedy, to the 
exclusion of others, but to consider such means as 
are known to myself and the profession by which 
woman may escape the pains and perils of mother- 
hood. That there may bo other effectual means I 
do not deny, but if such there are, I have not 
learned of them. 

Were I to consider one remedy or plan and not 
others, I would greatly diminish the value of this 



ANESTHETICS. 153 

book, and in all probability, deprive many anx- 
ious readers of the means of amelioration and re- 
lief. There are some who can avail themselves of 
one of the plans described and cannot of the others, 
while in some the combination of all the means 
may be necessary. The directions laid down in the 
three preceding chapters will, in a very large per 
cent, of cases, render the administration of anaes- 
thetics unnecessary ; but in the cases in which their 
employment is demanded, it is my desire that she 
know of their value and safety, and, by their proper 
use, we shall succeed if all other means should fail. 
I do not make any claim to being the first to ad- 
vocate anaesthetics in labor, or to the discovery that 
these agents can overcome the pains of childbirth. 
It is nothing new to many ; but common as it is, it 
is no less a fact that thousands of women suffer 
without it, and will continue to suffer until they 
are taught to demand relief at the hands of their 
medical attendants. 



154 PAINLESS CHILDBIRTH. 



CHAPTER IX. 



MANAGEMENT OF LABOR. 

The Period When it Should Occur — The Code Napoleon — In- 
stances of Protracted Labor — Preparations for Labor — Pre- 
monitory Symptoms — Indications of Labor — True and False 
Pains — Management After it has Begun — Remedies for Rig- 
idous — Encouragement — Progress, etc. — Ineffectual Labor — • 
How Overcome — Flooding — The Cord — The Afterbirth — 
Care of Mother and Child — Learning the Child to Nurse — 
After Birth — Superstitions — Disposal. 

At the expiration of nine calendar months, or 
more definitely, two hundred and eighty days after 
conception, the foetus having advanced far enough 
in physical development to maintain an independ- 
ent existence, is separated from the 1 mother by a 
natural process termed labor, or childbirth. 

It is possible for the foetus to survive if this pro- 
cess should occur at an earlier period, and instances 
are not uncommon of survival at the end of the 
seventh month, or even earlier, and instances are 
reported where the infant has survived birth at 
the end of five months; but it must be conceded 
that such cases are extremely rare. 

When labor occurs before the end of the ninth 
month it is said to be premature. 

On the other hand, we have abundant and well- 



MANAGEMENT OF LABOR. 155 

authenticated evidence to show that pregnancy 
may be protracted beyond the customary period 
of two hundred and eighty days without any seri- 
ous detriment to either mother or child. It ordi- 
narily occurs within a few days of the average time. 
The laws of nature, however, are not absolutely 
invariable, and no harm need be apprehended 
should the deviation amount to two or three weeks. 

Considerable difference of opinion exists among 
scientific physicians regarding the extreme limit of 
variation. The French have enacted in their Code 
Napoleon that a child born within three hundred 
daj r s after the death or departure of the husband, 
or one hundred and eighty days after marriage, 
shall be declared legitimate. This code admits that 
the legitimacy of a child born beyond three hun- 
dred days may be contested. 

Prof. Meigs published a case, which he regarded 
as trustworthy, of the prolongation of the pregnancy 
to four hundred and twenty days, or sixty weeks; fourteen 
months, or five months beyond the ordinary term. I 
merely mention the fact without any expressions of 
belief or doubt. Prof. Atlee mentions two cases of 
prolongation to three hundred and fifty-six days. 
Out of one hundred and sixty cases Dr. Elasser 
found that eleven were protracted to a period vary- 
ing from three hundred to three hundred and eigh- 
teen days. Sir James Y. Simpson mentions four 
cases in his own practice in which pregnancy was 
protracted to three hundred and thirty-two, three 



156 PAINLESS CHILDBIRTH. 

hundred and twenty-four and three hundred and 
nineteen days respectively. 

The time elapsing between the end of the seventh 
month and delivery appears to be more for the pur- 
pose of perfecting such foetal development as has 
been already begun, than for any new development 
essential to the maintenance of life. During this 
time the various organs become more capable of 
carrying on the functions for which they were des- 
tined, and it is during this time that the greatest 
proportionate increase in size and weight occurs. 

The cause of labor at this particular period is 
shrouded in more or less of mystery, yet the opinion 
seems to be gaining ground that it is due to changes 
in the structure of the placenta and its membranes, 
or as they are more commonly called, the afterbirth 
The foetus being capable of maintaining its inde- 
pendent existence, the destiny of the placenta as a 
connecting link between mother and child has been 
fulfilled, and it undergoes retrograde metamorpho- 
sis — fatty degeneration — its attachments to the 
Walls of the uterus are gradually severed, and the 
separation has been so far completed by the end of 
the ninth month that its expulsion as a foreign body 
becomes necessary, which is effected by the uterine 
contractions immediately, or very soon after the birth 
of the child to which it is yet attached by the cord. 

In the following directions for conducting a 
labor it is not presumed to interfere with the duties 
of the medical attendant, who should be present from 



MANAGEMENT OF LABOR. 157 

the beginning to the completion of the process. 
Neither is it expected that the readers will assume 
the responsibility of management, but it is hoped 
that by these and the foregoing directions the patient 
and physician may be aided, the labor rendered 
short, safe and easy. 

Certain preparations should be made in ad- 
vance, particularly the clothing of both mother and 
child, the bed and its dressings. 

The mother should be provided with an abun- 
dance of napkins and soft cloths that may be at hand 
whenever desired. Chemise and night-dresses 
should button in front and not be too long, so that 
they can be readily changed when soiled ; during 
the labor she should wear a loose gown, of any light 
material, so as to admit of the greatest freedom of 
motion. No clothing should be worn suspended by 
bands at the waist. 

If it is decided that she wear the time-honored 
lying-in bandage after she is delivered, it should 
be prepared and adapted to the size and shape of 
the woman beforehand, so that no necessity for ex- 
temporizing one when needed will arise. Of late 
years the bandage is falling into disuse, some phy- 
sician believing it more harmful than otherwise, an 
opinion doubtless originating in the abuses to which 
it is too often subject. When extemporized from a 
towel, sheet, straight piece of muslin, or anything 
handy, it will be simply impossible to retain it in a 
position where it will be a source of comfort and 



158 PAINLESS CHILDBIRTH. 

benefit. Thus extemporized, it soon slips above the 
prominence of the hips into a fold round the waist, 
where it exerts a pressure that is uncomfortable and 
harmful. If a bandage cannot be properly adjusted 
and retained in position it had better be dispensed 
with entirely. But when properly made and gored 
so as to fit the hips and abdomen and not slip up- 
ward, it is a source of very great comfort. It should 
be the widest over the hips, where there is the great- 
est space required, and narrowed above and below, 
and, if necessary, may have straps between the 
thighs. If made at about the fourth month, and 
fitted to the size of the body, with a small margin for 
allowance, it will not be far from right at the time 
it is wanted. It should be from twelve to sixteen 
inches in width, and may be made to lace, button, 
hook, buckle or pin. 

When it can be had, a lounge or cot-bed prop- 
erly arranged is the most convenient couch on which 
delivery can take place, for it permits to the best 
possible advantage the assistance of the attendants ; 
can be readily moved to suit any necessity, and pre- 
serves the bed, in which she must subsequently lie, 
dry and comfortable. This temporary bed should ♦ 
be moderately hard and firm, so that it may not sag 
downward beneath the hips of the woman ; the head 
should be a little the highest, and the foot provided 
with a convenient, narrow foot-board, at an agreea- 
ble angle of inclination, against which she may 
press with her feet during her expulsive efforts. A 



MANAGEMENT OF LABO& 159 

sheet should be twisted into a cord and fastened to 
tiie foot-piece for her to grasp in her hands and pull 
upon during the " bearing down pains." It is need- 
less to add that this temporary bed should be of suf- 
ficient width for convenience, that she may turn 
herself from one position to another to lessen the 
fatigue of unnecessary restrain. 

To prevent the bed or mattress from becoming 
soiled and wet, and more particularly if the tem- 
porary bed is not employed, a piece of oil cloth, 
rubber cloth or oiled silk, at least a yard square, 
should be placed over it, and above which an old 
quilt, folded in four, should be spread ; and, if de- 
sirable, over and above this a folded sheet to absorb 
the fluids as they are discharged, and admit of easy 
removal by being pulled toward the foot without 
disturbing the bed and clothing that is to remain. 
When the permanent bed is to be used the same 
preparations will be made, with the additional one, 
to see that sufficient extra folds of bedding be placed 
under the mattress in the center to prevent sagging. 
Then let the bed, if possible, stand in the center of 
the room. 

The clothing provided for the anticipated 
guest should consist of a plain piece of some soft 
woolen material for a binder. It should be wide 
enough to extend from the arm-pits to the lower 
portion of the abdomen, but not far enough to pre- 
vent the child from drawing the knees up to the 
abdomen, usually four to six inches wide and about 



160 PAINLESS CHILDBIRTH* 

fifteen inches in length, or long enough to go about 
one and one-half times around the body, the fold 
coming over the abdomen. Next a shirt, then pet- 
ticoat, and finally a dress, none of which should be 
starched, and the shirt and binder should be free 
from embroidery. Aprons, bibs, stockings, diapers, 
etc., should also be provided. 

In addition, there should be a pair of scissors, 
pins, linen cord, toilet soap, fine sponge, a jar of 
pure lard, a piece of soft muslin or linen for dress- 
ing the naval, a box of some unirritating powder, 
such as is sold by druggists for baby powder ; towels, 
etc., in abundance, and all placed convenient and 
ready for use when needed. Warm and cold water 
should always be at hand. 

The premonitory symptoms of labor are 
generally manifested for a period of time varying 
from one to two days to as many weeks. Subsidence 
of the abdomen is one of the most prominent. The 
stomach and lungs being greatly relieved of the 
pressure which they have borne for some time, the 
sense of oppression occasioned by this pressure dis- 
appears and the woman feels unusually well, bouy- 
ant and light. This symptom may be so deceptive 
that she will venture abroad, and perhaps by her 
unusual efforts induce labor under ludicrous and 
annoying circumstances. Women who have borne 
children attach considerable importance to this 
sign. Another sign is an increased fullness of the 
external parts and an augmented secretion, which 



MANAGEMENT OF LABOR. 161 

may even become so profuse as to necessitate the 
employment of a napkin. There may be painless 
uterine contractions and a sense of anxiety experi- 
enced, fidgetiness, sometimes a depression of spirits 
and other symptoms of less importance. The dis- 
charge is an important sign, particularly if accom- 
panied by a chill and the fullness of the parts above 
mentioned, and is usually followed by labor in the 
course of twenty -four hours. 

Indications that labor has begun are at first 
more or less variable and deceptive. There is apt 
to be a desire to pass urine frequently and evacuate 
the bowels. In many cases there will be a marked 
chill. A symptom of great value, however, is what 
is denominated as the " show," which consists of a 
discharge of glairy mucus mixed with a little blood, 
and is soon followed by the " pains," which recur 
periodically at intervals of an hour or less. These 
"pains " may be true or false. 

The false pains are caused by spasmodic action 
of the diaphragm and abdominal muscles, the spas- 
modic and irregular contraction of the circular 
fibers of the upper portion of the uterus, and are 
mostly felt in the abdomen, and are irregularly con- 
tinuous ; they are limited in extent and are not at- 
tended with an increase of the discharge, nor 
dilation of the neck of the uterus or protrusion of 
the " bag of water." These pains have a tendency 
to constantly shift from place to place. 

True labor pains, on the other hand, commence 



162 PAINLESS CHILDBIRTH. 

in the lower part of the uterus ; are first felt in the 
back and gradually extend to the front and into the 
thighs, recurring with regularity and increasing 
severity, pow r er and frequency, until having attained 
their greatest intensity they remain stationary a 
moment and then subside, and are followed by an 
interval of repose. They dilate the neck of the 
uterus and protrude its contents. During the con- 
tinuance of a true " pain, " if the hand is placed upon 
the abdomen over the uterus this organ will be felt 
contracting and becoming harder with the pain as 
it advances, and to become softer again as the pain 
passes off. 

Having already pointed out the means by which 
the pains of childbirth are to be avoided, and using 
the term pain so freely in this chapter, may seem 
rather inconsistent or paradoxical, but it is only ap- 
parently so. Heretofore we have used the term pain 
to indicate distress and suffering, but in this connec- 
tion we use the term to signify uterine contraction, 
which, as has already been shown, may be painless. 
The reason for this paradox is, that by common con- 
sent the word "pain" in obstetrical parlance is used 
synonymously with uterine contraction, which is, 
under ordinary circumstances, attended or immedi- 
ately followed by suffering more or less severe. 
With this explanation the author hopes to be for- 
given if he continues to use the term according to 
custom. 

True labor pains exhibit different characteris- 



MANAGEMENT OF LABOR. 163 

tics, according to the stage of the process. At first 
they are "cutting" or "grinding," short, severe, sit- 
uated in the back, extending to the abdomen, loins 
and thighs, and are confined to the first stage of 
labor, while the neck or mouth of the womb is dilat- 
ing to admit of the exit of the child. As the first 
stage changes to the second, the pains become " forc- 
ing" and "bearing down." The woman can no 
longer conceal them if she should wish to, but invol- 
untarily she aids them with expulsive and straining 
efforts. During the first stage the suffering may be 
considerable if any abnormal condition exists, and 
the patient will be apt to be irritable, restless, peev- 
ish, and perhaps despondent ; she desires to be con- 
stantly changing position, but as the pains become 
more forcing in character, this condition passes off, 
and instead of wishing to avoid or retard them, she 
involuntarily does everything in her power to aid 
them. 

Any question that may arise during the progress 
of the labor is to be settled by the medical attend- 
ant, and as early as possible after the labor has be- 
gun an examination should be made, with a view to 
determine the progress of the labor and the present- 
ing portion of the child. It should be made early, 
so that any malposition may be corrected before ad- 
vancement renders it difficult. This tactile exam- 
ination should be repeated sufficiently often that 
the physician may keep himself or herself informed 
of the progress of the labor, but should not be re- 



164 PAINLESS CHILDBIRTH. 

peated so often as to retard the labor, or become 
obnoxious to the patient. 

If, during the first stage of labor, the examination 
reveals the mouth of the womb hard and rigid, and 
not dilating as it should, pain frequent and tor- 
menting, I would expect speedy relief to follow the 
administration of the following prescription : 

Fluid Extract GelserninuHi, . . 15 drops. 
Fluid Extract Lobelia, ... 15 drops. 

Water, 2 ounces. 

Dose — A teaspoonf ul every fifteen minutes until relieved. 

It not unfrequently happens when this is the case 
that nausea and vomiting occur, which seems to be 
nature's method of overcoming this opposing rig- 
idity and exciting the mucous secretions for the pur- 
pose of lubricating the passage and expediting 
delivery. 

The bowels should always be freely unloaded 
before the labor has progressed very far, and for this 
purpose the employment of an injection of warm 
water is appropriate. To wait for a cathartic is often 
out of the question, and the physician who reads 
this will doubtless appreciate the advice to use the 
injection, particularly if he has ever attended a case 
in which the operation of a cathartic and the ter- 
mination of labor occurred about the same time. 

Nature usually provides for the lubrication of the 
maternal passages by an abundant secretion of mu- 
cus, together with the " waters," but if for any reason 
the mucus is scanty, or the waters discharged unus- 



MANAGEMENT OF LABOR, 165 

ually early, an artificial lubricant may be used to 
advantage, for which sweet oil, or the mucilage of 
slippery elm are perhaps the most appropriate. 

During the progress of labor the position of the 
patient is one of considerable importance, yet I do 
not believe in compelling the patient to remain in 
any one position. During the first stage of labor 
there is no good reason why she may not remain 
up and about the house if she chooses, and even 
when the delivery takes place, the position is more 
a matter of choice and convenience than necessity. 
Nearly all works on the subject of midwifery men- 
tion the position on the left side as the desirable 
one, and some attendants insist that the woman oc- 
cupy this position from the beginning of the second 
stage of labor to its completion. So far as my ob- 
servation goes, few women select this position them- 
selves. Some will get upon their hands and knees 
upon the floor, a few in various other positions ; but 
by far the largest proportion prefer lying upon the 
back with the head elevated, the knees bent, the 
feet braced, and the hands grasping something upon 
which they may pull during their expulsive efforts. 
The safety of the child, and the attention the mother 
will immediately require, are the most important 
considerations to be observed in the selection of po- 
sition, and there is little or no objection to a frequent 
change of position up to the last moment if they 
desire. 

The room is to be kept as quiet as possible — not 



166 PAINLESS CHILDBIRTH 

too dark nor too light — and at a temperature most 
agreeable to the patient. Too many persons should 
not be allowed in it, and those should be the ones 
chosen by the patient herself beforehand, and should 
be selected on account of their confidential relations 
to her, their sympathy, good sense, experience and 
endurance. No conversation should be permitted 
that is disagreeable, exciting or depressing. She 
needs sympathy, encouragement, confidence and 
fortitude. Nothing can be worse than to have those 
upon whom she relies filling her mind with fear or 
discouragement. Their sympathy must never per- 
mit them to give vent to sorrow by expressions of 
grief 

During the first stage the ordinary diet may be 
allowed, and at last, such warm drinks as she may 
desire. 

Much harm is often done by advising the woman 
to "bear down," and make expulsive efforts too 
early, by which she is only worn out and exhausted 
without accomplishing advancement. Until the 
womb has been dilated to admit of the passage ol 
the child, no amount of expulsive effort on the part 
of the mother will avail. 

It is wrong to rupture the " bag of waters " until 
this dilation has been effected, for it acts as a wedge 
that prepares the passages and advance of the child. 
It is usually ruptured at the beginning of the sec- 
ond stage and comes away with a gush. If it is 
ruptured before dilation occurs it will have a tend- 



MANAGEMENT OF LABOR. 167 

ency to retard the labor. If it is not ruptured spon- 
taneously after the womb is well dilated and the 
labor well advanced, this can be easily done with 
the finger nail. There is more danger of rupturing 
it too early than too late, and for this reason inter- 
ference should be well considered before undertaken. 
These remarks are intended more particularly for 
the unprofessional, though we know of some physi- 
cians who would do well to consider them. It is 
presumed, however, that the physician in attendance 
will know his business and exercise his judgment, 
to which bystanders are expected to yield. There 
are some cases where the labor will proceed to a ter- 
mination in his absence, and in such cases the full 
force of this chapter must apply. 

As the labor nears its termination, the pains are 
apt to become more protracted and forcible, and 
often more frequent, and are sometimes attended by 
cramps in the limbs. These latter may usually be 
relieved by friction. An examination will reveal 
the presenting part of the child pressing upon the 
perineum or floor of the pelvis, where it may be felt 
to advance and recede with each pain, gaining a 
little each time. 

The exertion now reaches its greatest height, the 
soft parts dilate and yield ; one pain follows another 
in rapid succession, so that one begins almost be- 
fore its predecessor has terminated, until, with a 
mighty effort, the head is expelled, after which a 



1GS PAINLESS CHILDBIRTH. 

short rest may occur, then with one or two more 
efforts the birth is accomplished. 

In the employment of anaesthetics I have always 
endeavored to so manage that during the last throes 
of labor, when the pain is most severe, to have the 
sensibility the most completely suspended. It aids 
in the relaxation of the perennial muscles, and in 
tliis way saves suffering and facilitates labor. 

Nearly all obstetric writers give explicit directions 
for supporting the perineum during the last few 
pains, with a view to prevent it from being ruptured. 
The support should be gentle, and not retard the 
labor, but merely to aid the perennial muscles in 
directing the head of the child in the axis of the 
natural outlet without tearing through the tissues. 
The support must be gentle, even and constant. 

Sometimes it happens that when the labor is well 
advanced, the efforts become less powerful and 
may be suspended altogether, owing to muscular 
exhaustion. It is then that certain remedial agen- 
cies may be called into requirement, and the ques- 
tion for physicians to determine is, whether he shall 
employ forceps to extract the child, or whether he 
shall make use of means to stimulate uterine con- 
traction, and thus effect delivery. It will be very 
seldom indeed that those who have carried out the 
advice given in previous chapters of this book will 
require a practical solution of this question. 

When, however, such an emergency shall arise, 
five to ten grains of the sulphate of quinine will 



MANAGEMENT OF LABOR. 169 

usually be adequate, and more particularly if her 
muscles are naturally very feeble. " If it is due to 
inertia of the uterine muscles, the spurred rye or 
ergot will be appropriate, of which one-half to one 
dram of a reliable fluid extract may be given every 
fifteen or twenty minutes until the purpose is ac- 
complished, I regard it as a good plan to combine 
the ergot and quinine, and give it at one dose : 

Quinine, ... . .5 grains. 
Ergot Fluid, . . . . y 2 dram. 
Repeat the dose every hour if necessary. 

This may be regarded as a large dose, but it is 
best to get the effect soon, if we desire to at all. The 
black cohosh, cimicifuga or macrotys, as it is vari- 
ously called, possesses similar qualities, and from 
ten to twenty drops of the saturated tincture or 
fluid extract, may be given every twenty minutes 
until the expulsive efforts are resumed. This latter 
remedy is open to one objection when given in suf- 
ficient quantity to produce this effect, and that is 
that it is liable to cause an unpleasant fullness and 
pressure in the head. The reader is referred to the 
consideration of this remedy in the chapter on re- 
medial measures 

Some practitioners regard it as a good practice to 
give, just a few minutes before the birth is accom- 
plished, a dose of one-half to a dram of ergot, with 
a view to secure certainty of contraction of the womb 
afterwards. This is a plausible theory, and though 
it may be done unnecessarily, yet little harm is likely 



170 PAINLESS CIITLDBIBTIL 

to result from it, and much possi' le good, and I have 
in many cases carried it out. 

As soon as the head of the child has made its 
exit, the mother experiences sensible relief, and 
may be assured that the worst is over. The whole 
body may follow at once, but usually there is a short 
pause, when, the body turning sidewise, it is expelled 
by another contraction. 

When the head has made its exit the nurse or 
some assistant who has been previously instructed, 
should make gentle pressure upon the uterus with 
her hands and follow it down as it contracts, and 
keep up the pressure firmly until the bandage is put 
on. When this is properly done it will secure the 
necessary contraction of the uterus, the after- 
birth will be quickly expelled and no trouble from 
hemorrhage will be liable. When flooding occurs 
in such cases, it is usually because the uterus does 
not contract and close the blood vessels, conse- 
quently the importance of the advice relative to the 
pressure upon and grasping, as it were, the uterus 
as the child is being expelled, is obvious. 

As soon as the head is born, it should be immedi- 
ately ascertained if the cord be wound around its 
neck or not, and if it is it must be loosened, for if 
this is not done the child may be strangled. Imme- 
diately after the child is born it is to be laid on the 
right side, its face free and exposed to the air, its 
mouth examined and freed from anv mucus that 



MANAGEMENT OF LABOR. 171 

may have accumulated, which will otherwise inter- 
fere with respiration. 

As soon as the child cries — and it is generally- 
sure to find out its abilities to do so very quick — 
the cord may be severed, and the birth, so far as 
the child is concerned, is complete. If the cord is 
free from the neck and cannot be felt to pulsate, it 
should be severed at once, whether the child cries or 
not. If it does not cry, artificial respiration is to be 
resorted to immediately, as described below. In sev- 
ering the cord, first take a waxed string, piece of 
tape, or other suitable material for a ligature, and 
tie around it two or three inches from the child's 
body ; tie the cord again an inch further from the 
child, and with a pair of scissors cut the cord be- 
tween the two ligatures, taking the oft-reiterated 
precaution to see that no part of the child is cut at 
the same time. 

Several homeopathic writes have advised against 
tying the cord at all, but severing without, as soon 
as the pulsation ceases. When the cord is severed, 
if the child breathes, it is to be laid upon a soft, 
warm cloth, prepared for its reception, and handed 
to the attendant, upon whom the duty devolves of 
washing, dressing and making it presentable. 

If there is any delay in the child's breathing 
after birth, let the cool air come upon its skin, which 
is a natural excitant of respiration, or blow in its 
face or mouth, or dash on a little cold water, slap it 
briskly upon the back and chest, apply brisk fric- 



172 PAINLESS CHILDBIRTH. 

tion all over it. Be careful, however, that it does 
not become chilled, and thus destroy its life. If this 
does not answer, inflate the lungs by blowing in its 
mouth, and then forcing out the air by pressing the 
chest, and repeat till it gasps. Grasping it by the 
ankles and swinging it with the head downward, 
has been recommended as an efficacious plan of re- 
storing suspended animation. I have never had 
occasion to try it. 

If the short interval that occurs between the ex- 
pulsion of the child's head and the rest of the body 
is protracted beyond two or three minutes, manual 
assistance should be rendered. Friction and firm 
pressure over the womb is to be made, and inserting 
a finger into the child's arm-pit, slowly extract it. 
No other course is left. Do not hasten too much 
lest you favor hemorrhage. Do not delay too long 
or you endanger the child. 

When there is no trouble about the child, a few 
moments suffice to secure its separation and removal, 
when the mother must be attended to ; she must 
not be neglected while the child is looked after. 

If the pressure before mentioned has been prop- 
erly carried out, the uterus will have contracted and 
detached the afterbirth, and it may be already ex- 
pelled ; but if it has not, and the flooding does not 
demand attention, the mother may be permitted to 
rest a few minutes before making any efforts to ex- 
tract it. 

If, after waiting half an hour, there are no after- 



MANAGEMENT OF LABOR. 173 

pains, friction upon the abdomen, grasping the 
uterus with one hand through the wails of the ab- 
domen, and with the other hand making gentle 
traction upon the cord, is to be resorted to, care be- 
ing taken not to use force enough to tear the cord 
from the afterbirth. When one or two efforts of the 
kind are not successful, the hand is to be introduced 
gently into the uterus, and grasping the afterbirth, 
at the same time keeping up the pressure from 
without, will generally cause a contraction and both 
hand and afterbirth be expelled together. 

When the hemorrhage is too profuse, give ten 
grains of gallic acid in a tablespoonful of water, or 
a teaspoonful of fluid extract of ergot, at once, and 
proceed to remove the afterbirth in the manner 
above advised, and apply the bandage, if such has 
not been done, immediately upon the birth of the 
child. I would apply the bandage as soon as possi- 
ble after the child is born, as it will favor contrac- 
tion, expel the afterbirth, and aid in controlling the 
hemorrhage. 

When the afterbirth has come away, ail the 
soiled clothing is to be removed from the mother, 
the parts cleansed with warm water and dried, 
and oiled with pure sweet oil, lard or vassaline, a 
soft, warm napkin applied, and dry, clean clothing 
put on; she is then placed in bed and allowed to 
rest. 

It is advisable to place under her a folded sheet 
or quilt to absorb the discharge that will continue, 



174 PAINLESS CHILDBIRTH. 

in such a way that it can be removed when soiled 
without disturbing the bed. Attention should be 
given that she does not suffer from exhaustive hem- 
orrhage, or make any exertion. She may lie upon 
her side or back, as she prefers. 

While this is being done the child should be 
receiving attention. It must be carefully washed. 
First, rub it thoroughly with lard or some bland, 
oily substance, and then carefully wash with toilet 
or castile soap and warm water. The oil is neces- 
sary to remove the cheesey secretion, soap and water 
not being sufficient, for if any is left it is apt to 
cause irritation and excoriations. Very often the 
skin diseases that occur to infants are due to care- 
lessness at the first washing. Rub the oil well in 
with the palm of the hand, and for washing use a 
silk sponge or very soft cloth. Remember the 
child's skin is very tender, and must not be treated 
at all harshly. Dry thoroughly. In performing 
this operation only a part of the child's body should 
be exposed to the air at a time. Attention should 
be given that every orifice of the body is thor- 
oughly cleansed. 

When the ablution is completed, examine the 
cord to ascertain that no oozing is going on, for if 
there is, another ligature must be put on. Take a 
piece of fine linen rag, two or three inches square, 
and cut a hole in the center large enough to pass 
the cord through, and lie on the abdomen. Take 
another similar piece, and wrap the end of the cord 



MANAGEMENT OF LABOR. 175 

in it, turn it to one side and apply the binder mid- 
dling firmly, and dress the child. This fragment 
of the cord generally dries, withers up and comes 
off in from four to six days. The time may vary a 
little, and no force should at any time be used to 
effect its removal. 

As soon as the child is dressed it should be 
put in bed with the mother and applied to the 
breast. By doing this, we in a very considerable 
degree avert the danger of flooding, and prevent 
what is known as milk fever about the third day, 
w T hich is apt to occur if the secretion of milk comes 
on suddenly. Another reason is that the mother's 
breast usually contains a secretion very desirable 
for the child to have, as it acts as a laxative and 
promotes the expulsion of the "meconium" — a 
tarry substance found in the bowels of a new born 
child. The same secretion from the mothers breast 
stimulates the liver, and is far better for the child 
than the horrid practice that frequently prevails in 
many portions of the country of feeding it with 
urine and molasses. Disgusting as such a prac- 
tice is, there yet remains among the ignorant and 
superstitious a belief that it is necessary for the wel- 
fare of the child. None outside of the medical pro- 
fession have any idea of the prevalence of such 
opinions. 

If the nipple is not prominent enough to en- 
able the child to grasp it, it may be drawn out by 
taking a bottle and filling it with hot water, or dip- 



176 PAINLESS CHILDBIRTH. 

ping it in hot water and applying it over the nip- 
ple. As it cools a sufficient degree of suction will 
occur to draw out the nipple, then apply the child 
immediately. If necessary, moisten the nipple with 
sweetened water to induce the child to take it. 

It would seem almost absurd to say anything 
about the disposal of the afterbirth, yet, know- 
ing as I do, that the traditions of a superstitious 
past cling with extraordinary tenacity to all that is 
concerned in reproduction, it may Hot be considered 
so much out of place. I have been amused at the 
ceremonies to which the afterbirth has been sub- 
jected by persons who were otherwise enlightened 
and intelligent. So far as the mother and child 
are concerned, it makes no difference what becomes 
of it, only that its complete removal is effected, and 
to burn it or bury it is a satisfactory and effectual 
method of disposal. 



MANAGEMENT AFTER BIRTH. 177 



CHAPTER X. 



MANAGEMENT AFTER BIRTH. 

Look after the Mother's Rest — Involution of the Uterus — Diet 
of the Mother — The Lochial Discharge — Danger of Neglect 
— When it is Unnatural what is to be Done — After-pains — 
Remedies — Attention to the Bladder — The Bowels — Bloat- 
ing — Milk Fever — The Nipples and Breasts — Xursing Sore 
Mouth — Remedies — Dosing and Stuffing the Young Eminent 
as Soon as it is Born — Nursing — Why it Should be Done- 
Milk for the Child — A Very Important Matter — Regulating 
the Sleep of the Child — Proper Food for Children — Wean- 
ing — Dress and Bathing — Moral Considerations — Medicine 
for the Baby — Bowels— Jaundice — Urine — Sore Eyes — Pre- 
scriptions — Vomiting — Diarrhoea — Remedies — Colic — Rem- 
edies — Teething — Its Troubles and Remedies. 

For a longer or shorter time after delivery, the 
mother will continue to require attention, while the 
care of the child has only just begun. The condi- 
tion of the mother will necessarily vary, depending 
very much on the ease with which she has passed 
the ordeal, as well as upon her previous physical 
condition. Her nervous system will have received 
a shock of variable intensity, and if the labor has 
been an easy one, or if she is robust and in a good 
condition to sustain such impression, the shock will 
be mild and of short duration, and in proportion to 
the subsidence will be her return to health and 



173 P^UNLESS CHILDBIRTH. 

The agitation caused by the labor will be succeded 
by a sense of lassitude and depression, similar to 
that which occurs after any severe exercise. The 
circulation will be affected ; the countenance will 
present a dull appearance, and it frequently happens 
that almost before she has reached her bed, she will 
be attacked by a chill, that may make her teeth 
chatter. Under ordinary circumstances this will 
soon pass off. The circulation will become natural, 
as manifested by a return of the regularity and full- 
ness of the pulse, the heat of the surface return, the 
skin moisten, every function become natural, and 
the most perfect, calm and delightful slumber 
follow. 

During this period a watchfulness is to be ob- 
served. 

If the shock is severe and prolonged, the prostra- 
tion extreme, respiration slow and sighing, or 
scarcely perceptible, the pulse slow and weak, or 
rapid, small and fluttering, interference will be 
necessary, and small quantities of stimulants may 
be given. Ammonia, wine, brandy or whiskey in 
any palatable form, may be given in small quanti- 
ties and often repeated, and gradually withdrawn 
as recovery becomes established. 

During this time the possibility of hemor- 
rhage must not b3 forgotten, for the symptoms 
already enumerated may be dependent upon loss 
of blood. Whoever officiates in the capacity of 



MANAGEMENT AFTER BIRTH. 179 

nurse must make frequent examinations to ascertain 
if the discharges are too profuse, or if they are 
wholly arrested. 

If the hemorrhage is too free, it may be controlled 
by cinnamon tea, five grain doses of gallic acid in 
water, or one-half teaspoonful of fluid extract of 
ergot, the doses to be repeated once in from one 
to four hours, as may be necessary. Few will re- 
quire such interference, and particularly if the di- 
rections previously given have been followed. 

During this time she must be kept quiet, the 

room slightly darkened, and no talking or whisper- 
ing is to be tolerated. She requires rest, sleep and 
recuperative repose, to restore her energies ; but 
during sleep she is not to be left wholly alone ; a 
competent person should remain with her to observe 
that nothing goes wrong. 

For the first few days she is to maintain the 
recumbent position, though she may frequently 
turn from side to side, or even sit up in bed ; but 
nearly all authors are united in advising that she 
remain in bed for the most part of her time until 
the ninth or tenth day. Women whose muscular 
tissue is more than usually feeble will do well to re- 
main even longer before any exertion is made that 
will require muscular effort. 

The reason for such advice is that the uterus, 
which has been considerably increased in weight 
during gestation, may have time to resume its 



180 PAINLESS CHILDBIRTH. 

proper size before its natural supports will be called 
upon to retain it in its proper position in the pelvis. 
By following such directions, the mother will ma- 
terially diminish the liability to uterine displace- 
ments. 

I am well aware there are those to whom such 
advice will seem a mockery. Some are compelled 
to disobey because upon their daily toil depends 
their supply of life's necessities ; others again, ac- 
customed to the hardships of life, will have devel- 
oped sufficient muscular power so that recuperation 
will not be to them the necessity it is to the weaker 
and more sensitive. In a previous chapter allusion 
to these circumstances has been made, 

After delivery the uterus undergoes a pro- 
cess termed involution, by which it resumes its 
previous size. On the perfection of this process 
materially depends the mother's future health. 
Having been increased in weight from sixteen to 
twenty times, or even more, it may be readily un- 
derstood what an arrest of this process of involu- 
tion implies. If this process is delayed there will 
be pain, weight, aching in the back, hysteria, and 
perhaps flooding. The hand over the abdomen can 
detect the uterus large and tender. There is often 
inflammation, or there may be a lack of muscular 
and nervous power — atony. When this is the case, 
flooding is liable. If the mother continues the use 
of the squaw vine and cohosh plants, already de- 
scribed there will b§ little danger of ^n arrest Qf lt\? 



MANAGEMENT AFTER BIRTH. 181 

volution ; but should it occur it will be best to 
employ a competent physician. 

During convalescence the diet of the mother 
is of importance. For the first three or four days a 
light diet is to be employed. Oatmeal gruel, tea 
and toast, light broth, and anything of an unstim- 
ulating character. This is to be maintained until 
the milk fever has passed, which generally occurs 
about the third day, if at all. When this secretion 
comes on gradually, but little disturbance will be 
noticed. 

If the diet is stimulating, the secretion of milk 
will be apt to be attended with considerable fever, 
painful and swollen breasts, etc., which it is desira- 
ble to avoid. If, however, the mother is feeble, a 
more nourishing diet will be necessary from the first, 
and beef tea may be given, mutton broth, etc. 
After the milk fever has passed, the mother may 
have a nutritious diet, milk, oysters, beef tea, 
mutton broth, rice, eggs, etc., etc., gradually re- 
turning to her customary diet, which should be very 
nutritious. 

After delivery a discharge termed the lochia 
takes place from the mother's genitals, varying in 
its duration in different women. In some it may 
dry up in a few days and in others continue for a 
month or even longer. Its too early disappearance 
may be followed by constitutional disturbances, and 
if not re established will result in ftn impairment of 



182 PAINLESS CHILDBIRTH. 

the general health, associated perhaps with some 
disease of the uterus and its appendages. On the 
other hand, if too long continued or too profuse, it 
will demand attention on account of causing 
debility. 

At first the discharge is composed largely of blood. 
After a while it changes in character, and has the 
appearance of a secretion. For a few days it is of a 
red color, but rather thinner and more watery than 
blood, and does not clot ; then it becomes yellowish, 
perhaps greenish, watery, with often the appearance 
of puriform matter, and finally of a soiled water 
appearance. It is accompanied with peculiar and 
sometimes offensive odor. Upon its free removal 
very much depends, and for this purpose soft nap- 
kins should be kept applied, and removed as often 
as they become soiled. To permit this discharge 
to remain in the bed and about the mother is sim- 
ply to endanger her life. It will develop fever and 
poisonous infection. To negligence of this simple 
precaution many a woman's life has been sacrificed. 

Frequent ablutions should be employed, as it 
often becomes acrid and excoriates the parts with 
which it comes in contact. This may be prevented 
by washing with warm milk and water, and appl} r - 
ing some bland, oily substance. When there is con- 
siderable fetor, and the discharge has the appearance 
of coming from a foul or unhealthy sore, its absorp- 
tion will be pretty certain to cause very serious 
consequences of which child-bed fever is a type. 



MANAGEMENT AJfTEZ BIETE. 183 

Under such circumstances I would advise that vag- 
inal injections of some antiseptic material be 
used. A wash of ten grains of permanganate of 
potash, dissolved in a pint of warm water and in- 
jected at once, does well. The same quantity of 
carbolic acid in a pint of warm water, is also good, 
and can be had at any drug store — and even if they 
could not, soap suds are always at hand and far bet- 
ter than nothing at alL 

Before using the carbolic acid or permanganate 
of potash, use a lotion of warm soap suds to wash 
away the decomposing and noxious fluids. Repeat 
the process from two to four times in twenty-four 
hours. Place the woman on a bed-pan and inject 
with any continuous syringe. If no bed-pan is at 
hand, fold an old quilt to absorb the fluids and pro- 
ceed. Absolute cleanliness must be enforced. 

There is no doubt but this discharge sustains an 
intimate relation to the uterine involution — that it 
is the method by which the uterus is relieved of 
what has now become superabundant tissue. 

Caseaux remarks : 

That discharge continues from delivery until the womb has 
regained its normal size and consistence. 

During the milk fever the lochia is generally 
diminished. Its suppression is caused by cold, and 
the mother should be extremely careful to avoid 
taking cold during its continuation. If it is sud- 
denly arrested there will be fever, general constitu- 



184 PAINLESS CHILDBIRTH. 

tional disturbance, bloating and tenderness of the 
abdomen, etc. 

As a remedy in such a condition, I have confi- 
dence in the administration of a tea of serpentaria 
root Add an ounce to a pint of boiling water, and 
give in one or two tablespoonful does every hour 
until the discharge is re-established. Aid it by a 
warm flaxseed poultice to the abdomen and genitals. 
If there is much pain and fever, one-half grain of 
powdered opium may be given in connection with 
these other means, and repeated in from two to 
four hours, according to the necessity. 

If the lochia becomes too profuse and ex- 
hausting, it must be modified ; a teaspoonful of 
wine of ergot may be given twice a day to improve 
the contractile power of the uterus, and some of the 
elixirs of cinchona and iron may be given two or 
three times a day for their tonic influence. These 
elixirs can be found in every well-regulated drug 
store, or may be substituted by one or two grains 
each of quinine and carbonate of iron at a dose. 

Usually, within an hour after delivery, uterine 
contractions will occur, which resemble more or less 
closely the throes of labor and are termed after- 
pains. As a rule, following the first delivery they 
are so slight as to occasion little or no annoyance, 
but become more and more severe with each suc- 
ceeding child. Most writers regard them as salu- 
tary, being necessary to expel the clots that have 
formed within the uterine cavity, and thus prevent 



MANAGEMENT AFTER BIBTE. 185 

hemorrhage, and to enable the organ to diminish its 
size. 

Prof. Bedford says : 

These pains are what are known as after-pains. They are 
nothing more than the contractions of the nterns ridding itself 
of the fluids contained within it, and at the same time, through 
these contractions gradually returning, as far as may be, to its 
pristine state. After-pains, therefore, instead of being regarded 
as morbid or pathological, are to be classed among the usual and 
necessary phenomena of childbirth. In a woman with her first 
child — a primipara — these pmns are ordinarily slight; in a 
multipara, on the contrary, they are oftentimes severe and har- 
rassing. The reason of the difference is that, in the former case, 
the uterus is invested with vigor and tonicity, and consequently 
soon becomes restored to its original condition ; while, in the 
latter, its walls are flaccid, and the contractions, therefore, more 
protracted. 

Prof. Bedford's words reflect to a great degree the 
opinions of the medical profession in this respect, 
and furnish us with a practical suggestion, viz. : 
The more nearly perfect the integrity of the uterus 
and its associate tissues, the less pain there will be 
after labor. 

This suggestion brings us back to a subject already 
partially considered in a previous chapter, in which 
directions are given for the removal of abnormal 
uterine conditions, and restoration of the muscular 
tissues to a healthy and vigorous state, by the em- 
ployment of the squaw vine, blue and black cohosh. 
True, our observations then were made with a view 
to relieve the pains of labor, but they hold equally 
good with reference to the relief or prevention of 



ISO l^UNLESS CHILDBIRTH. 

after-pains. I can assure the reader that this is not 
an unfounded hypothesis, but an established fact 
often demonstrated. 

There are those, however, who have not had the 
advantage of previous preparation, and for the re- 
lief of such, it is highly proper to consider the 
remedial resources at our command. When these 
pains are protracted by a lax and enfeebled con- 
dition of the uterus, a small dose of ergot will often 
promote the contraction, and thus diminish their 
repetition. The remedial influence of the black 
cohosh or cimicifuga is similar, and may be con- 
tinued while the after-pains last, in doses of five 
drops of the fluid extract or homeopathic tincture 
in water, repeated every three or four hours. 

When these remedies are unavailing and the suf- 
fering great, it may become necessary to resort to 
opiates to diminish sensibility to pain. Opiates, 
however, do not always act kindly, and when this 
is known they should be avoided. When it be- 
comes necessary to resort to opiates, one or two tea- 
spoonfuls of paregoric is generally sufficient, or 
one-sixth to one-fourth of a grain of morphine, or 
five to ten grains of dover dowder. I prefer to 
avoid opiates if possible, as they are apt to derange 
the secretions, and the black cohosh has usually 
met my expectations. 

It not unfrequently happens after a somewhat se- 
vere or tedious labor, that the woman will lose con- 



MANAGEMENT AFTER BIRTH 187 

trol of the bladder, and either be unable to 
discharge the urine at all, or perhaps it will con- 
stantly dribble away from her as fast as it is formed. 
In other cases she may have power to pass or retain 
it, but its passage will be painful, and the urethra 
remain sensitive and tender. 

When she is unable to discharge the urine and 
the bladder is distended and painful, the catheter 
should be resorted to, and it is a very easy matter 
to draw off the urine if the operator knows how. As 
no one but a physician would be likely to attempt 
to pass a catheter, no necessity exists here for de- 
scribing the operation. The woman should make 
an attempt to pass water in the course of six or eight 
hours after delivery. The first attempt will quite 
likely be somewhat painful, and if the urine is hot 
and burning, it may be well to resort to anodyne 
diuretics, and a teaspoonful of sweet spirit of nitre 
may be given in a cup of flaxseed tea. If this does 
not afford reiief it may be repeated, and two drops 
of tincture of belladonna added to the next dose. 

Should the woman be unable to pass her urine in 
from ten to twelve hours, and there is any evidence 
that there is any urine in the bladder, before mak- 
ing use of the catheter the following expedients 
may be tried : Apply hot wet cloths to the lower 
abdomen and external genitals, or a warm flaxseed 
poultice ; the warmth and moisture will often relax 
the tissues and the discharge take place. 

The influence of the mind upon matter is often 



183 PAINLESS CHILDBIRTH. 

illustrated in cases of the kind, as stated by Prof. 
Bedford in his Principles and Practice of Obstetrics. 
IJe says : 

I somewhere read years ago of the practice in these cases of 
pouring, within the hearing of the patient, water from a, vessel 
slowly into a pitcher ; and I can vouch for its efficacy in several 
cases in which I had recourse to it. * ^ * % * 
It is a curious, but interesting circumstance that, occasionally, 
after the patient has made vain attempts to relieve herself, and 
the failure of the ordinary remedies, the moment the accoucher 
suggests the necessity of having recourse to an instrument for 
the purpose of drawing off the water, madam, alarmed at the 
idea of an instrument, tells the nurse in an undertone, ' Oh, I 
think I can relieve myself now.' The nurse brings the bed-pan, 
and sure enough the bladder is evacuated. Some persons can- 
not evacuate either bladder or bowels upon a bed-pan, but seated 
upon an ordinary chamber vessel they find it easy enough, and 
particularly if it is half filled with hot water. 

When the urine dribbles away without any 
control, a few drops of tincture of belladonna will 
generally rectify the trouble. Give a drop ever}?- 
hour or two until several doses have been given. Jf 
this fails to be prcd ictive of good effects, Bedford 
recommends ten drops of tincture of cantharides 
twice a day in a vine glass of flaxseed tea. 

In some cases the kidnejs will fail to se- 
crete any urine, and there will not be any in the 
bladder to evacuate. In such cases the remedies 
must be addressed to the kidneys instead of the blad- 
der, and a convenient and reliable prescription will 
be found on pages 102 and 103. 

The custom prevails in many parts of the country 



MANAGEMENT AFTER BIRTH. 189 

of giving the lying-in woman a dose of physic upon 
some certain day after confinement — usually the 
second or third, There is no necessity of such a 
proceedure unless the condition of the bowels de- 
mands it, and if the woman has kept her bowels in 
proper condition before, there will be little necessity 
for cathartics now. 

When, however, a necessity for opening the bowels 
exists, the employment of a dose of castor oil the 
second or third day generally suffices, and also an- 
swers the additional purpose of establishing a flow 
of milk. 

If the condition of the milk does not require any- 
thing of the kind, a seidlitz powder, a dose of cit- 
rate of magnesia, or an injection, will be equally 
satisfactory, and often far more acceptable to the 
mother's palate. 

An accumulation of gas in the bowels will 
give rise to distention and suffering, sometimes 
amounting to severe distress. Pressure will cause 
pain, which may be mistaken for inflammation. In 
distention, the swollen abdomen will sound like a 
drum if gently tapped upon, and pressure though 
at first painful, will, if gentle and continued, soon 
give relief, while if inflammation is present, the 
longer the pressure is continued the more painful 
it will become. 

In this trouble few if any remedies can equal tur- 
pentine. Add one-half to one teaspoonful of 
" spirits " of turpentine to an ordinary dose of cas- 



190 PAINLESS CHILDBXBTIl: 

tor oil and take at a dose. If the taste is offensive 
it may be given in capsules or syrup of gum arabic. 
The application of a warm flannel sprinkled with 
turpentine to the abdomen is also beneficial. An 
excellent homeopathic remedy is bryonia, of which 
five drops of the tincture is to be dissolved in one- 
half glass of water and a teaspoonful given every 
hour. 

Ordinarily, in from twenty-four to forty eight 
hours after delivery a febrile reaction, more or 
less severe will be experienced. If the diet of the 
mother has been stimulating, the fever will be more 
severe than otherwise. If the breasts have been 
filled with milk for some time, but little fever will 
be likely to occur. There may be a chill, followed 
by fever, rapid pulse, headache, unrest, and a more 
or less complete arrest of the lochia. This phe- 
nomena may be accompanied by distention and 
pain in the breasts, hence the term milk fever. 

This will usually pass off in a few hours, and 
generally does not require any treatment. When 
severe, sponging the skin with tepid water, in which 
a little soda has been dissolved, may be employed, 
and a few doses of aconite given to promote sweat- 
ing and abate fever. Put five drops of the tincture 
in half a glass of water, and give a teaspoonful every 
hour. 

If the mother has taken the proper precautions 
to harden the nipples with astringents, and sub- 
jected them to handling by rubbing between the 



MAXAGEME2TT AFTER BIUTE. 191 

thumb and finger, their tenderness will have been 
diminished and she will not be liable to trouble, 
But if she has not given the subject any attention, 
in a few days after the child begins to nurse they 
will become exquisitely sensitive and painful. An 
application of the child will be an absolute punish- 
ment, and nursing will be a severe struggle between 
duty and physical suffering. The nipples are liable 
to become excoriated or cracked, and being con= 
stantiy in use are difficult to cure, for every time 
the child nurses it opens the fissures anew. When 
the pain becomes so great that the mother can not 
tolerate the efforts of the child, she becomes liable 
to another affliction. The breasts become engorged, 
inflammation ensues, an abscess forms and she has 
a. "broken breast." 

When the nipple is exeorlatad, the applica- 
tion of astringents is appropriate, and an ointment 
of galls may be used after nursing. When there is 
merely tenderness, borax and water is a good appli- 
cation — brandy and water, or tincture of myrrh 
may be applied. If the nipple is fissured, it is a 
good practice to unite the edges of the fissure as 
closely as possible and cover it with collodion, which 
forms an artificial skin of sufficient firmness to ad- 
mit of the child's nursing without being removed. 
It must be prepared by adding about one part of 
Venice turpentine to six parts of pure collodion, or 
it will be apt to contract so much on drying as to 
cause pain. In using it I would apply to the fissure 



192 PAINLESS CHILDBIRTH. 

a solution of five grains of nitrate of silver in an 
ounce of water, and as soon as dry put on the collo- 
dion with a brush, applying several layers until it 
is sufficiently firm to hold and keep the fissure 
closed and protect it from the child's mouth. Re- 
peat the process as often as it comes off or gets 
loosened. A great variety of rubber shields are to 
be had, from which protection may almost always 
be selected. 

Abscess of the breast may be due to the cause 
just described, to cold, to injury, etc., but is oftenest 
due to carelessness in neglecting to have the milk 
properly drawn. The affected breast becomes 
" caked/' swollen, painful. As soon as anything of 
the kind is noticed apply warm poultices, and ab- 
stain from taking much fluid. Camphorated oil 
makes a good application. I have also found the 
oil of peppermint painted over the entire breast a 
very effectual and agreeable remedy, and should be 
frequently repeated. The breasts should be sup- 
ported and not be allowed to hang down, which in- 
creases the trouble. They may be held firmly in 
position by several turns of a broad roller bandage 
around the body. As an internal remedy give : 



Tincture of Aconite Root, . 


. 10 drops. 


Tincture of Belladonna, . 


. 10 drops. 


Tincture of Poke Root, . 


. 20 drops. 


Water, 


4 ounces. 



Dose — A teaspoonf ul every hour or two until the inflamma- 
tion subsides. 



MANAGEMENT AFTER BIRTR. 193 

If matter forms, as soon as it can bo detected, 
evacuate it with the knife. 

During nursing, and sometimes during the latter 
months of pregnancy the mother may be afflicted 
by a peculiar species of sore mouth, which 
may be so severe as to cause great suffering and se- 
riously interfere with the taking of food. This 
condition is supposed to depend upon some pecul- 
iar unhealthy state of the lobod, and is oftenest 
found in those who are suffering from an impaired 
condition of the general health, among the scrof- 
ulous, etc. 

The treatment consists in improving the general 
health. Cinchona, iron and quinine, maybe taken 
with a nourishing diet, and the mouth washed with 
borax and glycerine in water, chlorate of potash or an 
infusion of the common gold thread or golden seal. 
Let them all be of a strength that can be used with- 
out causing much pain. I have found the baptisia 
an excellent remedy. I have usually given it in 
doses of fifteen drops of the tincture three or four 
times a day. The remedy can usually be obtained 
at first-class drug stores. It is also called wild indi- 
go, horse-fly weed, etc. The homeopathic remedies 
most likely to suit are arsenicum, mercurius, nitric 
acid, etc. 

Although a consideration of the child after the 
delivery is completed does not come within the 
scope of painless childbirth, a brief allusion to the 
care of the young " eminent " cannot be far out of 



194 PAINLESS CHILDBIRTH. 

place, and a few pages on the subject will perhaps 
be tolerated by those readers who have borne with 
us thus far. 

Almost simultaneously with birth does feeding 
and physicing begin. So extensive is the prac- 
tice that a baby may consider itself extremely for- 
tunate if it escapes a uhole hour after it is born, 
without having to take something, and from that 
time forward there is always a teaspoonful of some 
food or drug waiting lor it. If ever it ventures to 
test its lungs or voice, it must be considered either 
sick or starving, and down goes the favorite " dope." 
Indeed they sometimes live in the world a whole 
day without getting their little mouths empty 
enough to enter an objection to the way business is 
done, by a cry. Ludicrous as such remarks seem, 
the^y are nevertheless too near the truth, for, from 
the baby's arrival it is expected to freely partake of 
" pap/' " sling," castor oil, paregoric, soothing syrup, 
etc., etc., or else it must eat every time it wakes up, 
if indeed it is not awakened to feed it,. 

I sincerely hope that those who read these pages 
will remember that the baby is not always sick 
nor hungry when it cries a little. More babies 
die from over, than under feeding. Nothing can be 
farther from my wish than to neglect these little 
strangers, but when we realize the growing tend- 
ency to keep them half stupid with opiates in the 
form of powder, paregoric, soothing syrup, baby 
syrup, and the like, we are sure our language is not 



MANAGEMENT AFTER BIRTH. 193 

half strong enough. There are times when opiates 
are needed, but to stultify a child's intellect and de- 
preciate its vitality by narcotizing, is an abomina- 
tion. 

Since the first edition of this book was published, 
I have had the pleasure of reading a very excellent 
work on baby feeding, entitled How we Fed the 
Baby, by Dr. C, E. Page, of Lewiston, Me., which I 
cordially recommend to the consideration of every 
nurse and mother in the land. 

While a child's stomach is intended to re- 
ceive nourishment quite often, it is to be remem- 
bered that one supply should be received and 
digested before another is needed. Great harm 
may be done by keeping the little stomach distended 
all the time. The infant is not capable of reasoning, 
and will often nurse when the stomach is distended 
with milk. It is not uncommon for it to worry and 
take the breast greedily, when the judgment of the 
nurse or mother should prevent. 

Usually at birth the breasts of the mother 

are filled with a peculiar secretion in which is found 
an element known as colostrum. This possesses some 
purgative properties, and will cause the child's 
bowels to move, and free the intestinal canal of the 
dark, tarry substance already alludecLto as the me- 
conium. This secretion from the mother's breast 
is better for this purpose than any drug, and for this 
reason the child is to be put to the breast early. 



196 PAINLESS C1IILDB1IITLL 

Another reason is, its efforts will induce a flow of 
milk. 

There is still another reason, and that is, a baby 
can be taught to nurse with less trouble before it 
has been fed with a spoon, than afterward. 

The breast may contain but little nourishment at 
first, but still the child should be regularly returned 
to it all the same, for the benefit of the mother if 
nothing else, as it causes the contraction of the 
uterus. At first it may cause her considerable pain. 

If there is no milk in the mother's breasts it 
will become necessary to supply artificial nourish- 
ment, and for this purpose diluted cow's milk is most 
appropriate. It may be diluted about half and half 
with warm water and a little sugar added. With- 
out entering into a consideration of the relative 
compositions of humam and cow's milk, suffice it to 
say that such a mixture is the most nearly perfect 
substitute at hand, and may be given about as often 
as the chiid would ordinarily be nursed, which is 
on an average about once in two hours during the 
day, and about once in three hours at night. This 
may be varied a little, and as the child becomes 
older, the intervals should be lengthened. Ordi- 
narily it may be permitted to take enough to satisfy 
itself. 

The experience of ages, and the dictates of com- 
mon sense all unite in declaring that the most 
natural food for a new-born infant is its 
mother's milk, provided she be in a proper state 



MANAGEMENT AFTER BIMTH. 197 

of health. As her blood has nourished it during its 
foetal existence, it is now her duty to nourish it with 
her milk. True, there are circumstances which will 
necessitate some other means of furnishing it sub- 
sistence, and if the mother cannot nurse it, the next 
best substitute is a nurse. 

In the selection of a wet nurse, obtain one as 
near as possible the age of the mother, and whose 
child is not much older than the child she is also 
to nourish. It is needless to say she must be free 
from disease. Even when the mother herself un- 
dertakes to nurse the child, if she becomes extreme- 
ly emaciated, or attacked by any disease, it is best 
that she transfer her charge to the breast of a hired 
nurse. 

When a proper nurse cannot be obtained, the 
next resource is cow's milk, which may be diluted, 
and have a little sugar added, as already stated, and 
as the child's age increases, the water and sugar 
should be gradually lessened. The sugar used for 
this purpose should be pure refined white sugar. 
Select one cow, if possible a young one, one that 
calved as near as possible about the time of the 
birth of the child. The animal should be perfectly 
healthly, properly fed, and milked regularly. The 
selection of cow's milk is of the greatest importance. 

If it is decided to " bring up " the child on cow's 
milk, select a suitable nursing bottle, with a 
nipple which will require the child to make a little 
exertion to secure the milk. Let the bottle be sim- 



198 PAINLESS CHILDBIRTH. 

pie and easy to keep clean. Never use it to refill 
without thoroughly cleaning. Sour, musty, de- 
cayed milk is not a success as a healthy nutriment 
for a baby, A filthy nursing bottle is exceedingly 
favorable to the development of disease germs, and 
a potent child destroyer. These may appear to be 
small matters, but they are potent in results. > 

The newer the milk the better — the more 
natural it will be. The mother's milk must be 
healthy and the diet must be appropriate, for it will 
have a great influence upon the child. If she eats 
any articles of diet that disagree with her it will af- 
fect the child. Medicines taken by the mother dur-. 
ing nursing will have an influence upon the child 
similar to the effect they have upon the mother. 

The child should be taught the habit of seeking 
the breast at regular intervals. This is easily 
done if undertaken at the commencement. We are 
more or less creatures of habit, and it is much easier 
to form a habit than to break one. Babies learn 
quickly and unlearn with difficulty. 

The evils of excessive nursing must be borne 
in mind, for it exhausts the mother and breaks her 
down. It may be that she may not have milk 
enough, then it will be necessary to rely partly upon 
cow's milk. Should the mother's health decline 
under nursing — her recuperative powers be inade-> 
quate to the demands of the child and her own sys- 
tem, she had doubtless better wean the child or 
resort to feeding it cow's milk, It is a mistake for 



MANAGEMENT AFTER BlRTh. 199 

her to take large quantities of liquids to make more 
milk, as it impoverishes her, and does little to ben" 
efit the child. If the liquids she takes are nutritious 
and improve her health and strength, as well as in- 
crease the flow of milk, they may be continued, 
otherwise abandoned. If she has too much milk, 
she must be very careful and not allow her child to 
nurse too much, and thereby injure it. 

I am often called upon to decide if beer or the 
preparations of nialt are beneficial, and I am 
inclined to believe they are, if they agree with the 
nursing mother. They usually improve the appe- 
tite, increase assimilation and aid nutrition, and in 
this w r ay aid the system to appropriate nourishment 
from food to supply the demand. If they fail to do 
this they had better be left off 

In infancy there is a necessity for consid- 
erable sleep, and when the sleep is calm and nat- 
ural it should be continued without interruption 
for considerable time. A young child will be apt 
to sleep between each feeding, and it is a question 
of importance to decide whether the child should 
be waked up to nurse. After the foregoing remarks 
on habit there cannot be much doubt on the sub- 
ject, and I w r ould advise that it be done, so that there 
may be as great a regularity about sleeping and eat- 
ing as possible, and if this plan is carried out the 
trouble will be materially reduced. Usually for the 
first month or two the child w T ill pass two-thirds to 
three-fourths of the twenty-four hours in sleep, 



200 PAINLESS CHILBBJIiTIL 

From the second to the sixth month, it will natu- 
rally sleep twelve hours at night, waking three or four 
times to nurse, and taking two or three naps during 
the day 

It should not be expected to sleep too much, for 
as it becomes old enough to notice objects it will 
amuse itself with playthings and not sleep so much. 
Until a child is two years old it will require a nap 
in the forenoon and one in the afternoon. As it 
grows older it will sleep less. By a wise provision 
of nature the amount of sleep in health w T ill usually 
regulate itself, though the mother may take advan- 
tage of it and divide the sleep during the day into 
regular intervals, for her own convenience and the 
welfare of the child. 

Do not bury it beneath a mass of heavy bed- 
clothes, nor cover it so lightly that it will be 
chilled. Maintain as nearly as possible an even 
temperature. The room should be moderately 
darkened while sleeping. There should be plenty 
of pure air, but care is to be taken that it is not left 
to sleep wheit, a current of air may blow upon it. 
Do not cover its face with the bed clothes. Give it 
plenty of room. A crib is better than to have it 
sleep in the bed with Hie mother. Its bedding 
should be freely and frequently aired, and kept free 
from all unhealthy odors. 

As a rule it will be best that the child be con- 
fined exclusively to its mother's, nurse's, or cow's 
milk until it is six months old. The organs of di- 



MANAGEMENT AFTER BIRTH. 201 

gestion in children are very easily deranged and 
many kinds of food are disproportioned to their di- 
gestive powers. Diarrhoea will often manifest it- 
self as a result of poor or unhealthy milk, and will 
also occur when food does not agree, and will cause 
more or less colic. 

When a child is six months old it may have 
a mouthful now and then of the mother's food, or 
arrow root, corn starch, powdered rice in milk do 
well ; powdered crackers are good, and from these 
simple articles a variety of nutritive and easily di- 
gested articles can be prepared. Begin at first with 
a very small quantity, and gradually increase. 
Variety is as necessary for children as for grown 
people. They become disgusted and tired of one 
kind of diet, and their constitutions require variety. 
This is an important point, and really is the secret 
of good nutrition in children. 

Meats are not much required except under direc- 
tion of a physician, until after weaning. Let them 
have a crust of bread when they get so they can 
hold it. They chew or suck, it and get nourish- 
ment; it teaches them to eat, amuses* them and 
favors teething. When the mother has carried out 
the fruit diet, and lived on non-osseous materials, 
the child should have food containing lime, and the 
various preparations of wheat are beneficial, but 
must be given in moderation. 

There will frequently arise circumstances that de- 
mand a change of diet. When the child does 



202 PLAINESS CUILDBIUTIL 

not thrive on milk, or is afflicted with cholera infan- 
tum, I would then give beef tea, mutton broth, etc, 
as a change, and they will sometimes be found to 
agree far better than milk People living in cities 
will often find it impossible to get milk that will be 
good. Then the artificial substitutes will be neces- 
sary. An article called "mincasea" may be tried 
in many instances with advantage. 

I am satisfied many children will die if we ad- 
here to a rule in selecting the diet, and I am con- 
vinced from experience that it is better to vary the 
quality and kinds of food given and lengthen the 
intervals between feeding, rather than to persistently 
adhere to one article of food, Various elemen- 
tary substances are required in the formation of the 
body and no one article of diet is likely to supply 
them all When anything disagrees it should be 
discontinued instead of forced. 

There are numerous articles of diet in the market 
for children — Liebig's, Ridge's, Horlick's eta — and 
they have some merit ; still from coarse wheat flour 
a diet can be arranged by the ingenuity of the cook 
that will be agreeable and beneficial. Care is to be 
taken to avoid overloading the stomach, and not 
feed it anything too rich for the digestion/ Milk 
must of a necessity enter largely into the composi- 
tion of its food the first year of its life. 

In feeding let the same regularity be observed 
as is advised in nursing, When the teeth have 
come, it can begin to chew, and meats may be 



MANAGEMENT AFTER BIUTH. 203 

given — the tenderest meat of a fowl, and they will 
enjoy eating it very much — broths, soups, gruel, 
-bread and milk. VvTien it has no teeth to masti- 
cate meats, eggs may be given. 

Until the child is three or four years old and per- 
haps older, it will need feeding oftener than the reg- 
ular hours at which its parents eat. It will need 
extra meals between breakfast and dinner and be- 
tween dinner and supper. Be careful to prepare its 
food well, 'and regulate the hours according to its 
needs. 

It is a very foolish idea to disregard the choice in 
food, or starve them to certain articles or frugality, 
in order to make them tough. Privations are 
not intended for infancy, and upon us depends 
their future, and we should endeavor to render their 
constitutions vigorous and energetic by a well- 
selected, well-regulated and sufficient diet. 

Give the baby a drink of water often. Man y 
mothers never think of this, and the little things 
suffer intolerably from thirst which milk does not 
quench. This causes babies to nurse when they do 
not need it. Offer it to the child frequentty whether 
it nurses or not. Don't be afraid of w r ater, and don't 
adulterate it. Pure, clear, cold water is as grateful 
to an infant as an adult, and will contribute to its 
health and good nature. 

It is often a question of considerable importance 
when to wean the little one. Nothing is gained 
by nursing too long when no circumstance demands 



204 PAINLESS CHILDBIRTH. 

it, and on the other hand there may be danger in 
weaning it too early. As a rule, from twelve to fif- 
teen months is the proper age. They should have 
been for some little time previously gradually in- 
ured to the substances from which they must here- 
after derive their nourishment, before the change 
is abruptly forced upon them. Should the mother 
become pregnant again during nursing it will be 
best that weaning take place at once. 

The season for weaning is important. During 
the hot weather, intestinal disorders are most prev- 
alent, and any digestive irregularity it is known 
will generally give rise to diarrhoea and other dis- 
orders of a similar nature, and unless some circum- 
stance renders it imperatively necessary, it is not 
best to wean during hot weather nor just preceding 
it. The mother should arrange to wean early in 
spring, so the child may become accustomed to dif- 
ferent food before the hot months, or she should 
defer weaning until those months during which 
there is the greatest infant mortality have passed. 
To wean infants in a city in hot weather is fatal in 
a very large per cent, of cases. Cow's milk in the 
cities in summer is always a question of serious in- 
vestigation, and no matter how carefully managed, 
it is certain if the milk is all right when it leaves 
the dairy, by the time the infant gets it, it will have 
been influenced to some extent. The country is 
certainly the place for babies in the summer. 

It is a popular, but mistaken idea, that chil- 



MANAGEMENT AFTER BIBTR. 205 

dren become accustomed to hardships by exposure, 
and this, together with vanity, which latter is often 
construed as maternal pride, often subjects them to 
a system of dress in which the very parts that 
should be covered and protected from the cold are 
exposed. If mothers are particular to expose to 
public view any portion of the child's body, let them 
cut out a piece from the clothing immediately over 
the heart, but keep the neck, arms and legs covered 
and protected. This pernicious custom of low- 
necked dresses and bare arms, while very pretty, 
is a fruitful source of catarrhal and pulmonary 
affections. 

The surest and safest way to toughen a 
child is to take every precaution so that it may 
pass through the first years of its life without any 
ailment. 

Every child should be clothed so as to thoroughly 
protect it from dampness and cold. As a rule, fine 
soft flannel, Canton flannel and calico are the mate- 
rials from which the clothing should be made. 
Fine, soft flannel next the skin, except where it 
would be too often wet, is better than cotton mate- 
rial. The dress should be loose and easy, to admit 
freedom of movement. It is to be sufficient in 
quantity to effectually protect it from atmospheric 
vicissitudes, and must be regulated by the season 
and the weather. 

Every article of dress worn through the day 
should be changed at night. 



206 PAINLESS CHILDBIRTH 

The advantages to be derived from regularity of 
bathing are usually underrated. The bath serves 
several purposes, of which cleanliness stands first. 

It is an absurd idea to bathe children in 
cola water. The sedative influence of the cold 
is too great ; it favors internal congestions, and 
often lays the foundation for serious diseases. 

Every morning the child should have a 
bath, the temperature of which may be gradually 
reduced until, after a few w T eeks, it is not much 
above the temperature of the room, but never to 
coldness. Usually in infancy the temperature may 
be near one hundred degrees. The water should 
not be too w r arm. After a time the morning bath 
may be reduced to eighty degrees, or even seventy, 
but it must not be done at once, nor should the 
child remain in it too long. 

The child can be soaked to death as well as not 
bathed enough. Some have an idea that a child 
cannot bathe too much. This is absurd. As a rule, 
a few minutes in the morning is enough — as much 
as should be tolerated. * 

In the evening a warm bath may be given 
for its soothing effect, and a sponge bath at the same 
time is most desirable, though if the child is irri- 
table and restless, immersion of the body for a 
couple of minutes will be beneficial, and if it is of a 
feeble disposition a little salt may be added to the 
evening bath. The child must not remain in long 
enough to induce perspiration after it has been 



MANAGEMENT AFTER BIRTH, 20? 

taken out and wiped dry; if it does, the bath will 
do more harm than good. An hour or two after 
eating or nursing should elapse before the bath is 
given. The room should never be cold, and care is 
to be taken that the child does not take cold. The 
skin is to be thoroughly dried after the bath with 
some soft material. Very little soap is necessary. 
There is but little oily matter to be removed from a 
child's skin, and warm water will usually remove 
other impurities. Whatever soap is used must be 
unirritating or it may cause skin diseases. 

As a rule, children are more intelligent and 
observing than supposed, and they quickly 
form habits that are not easily broken. They 
seldom thrive well when peevish or fretful, while 
good natured children are most generally healthy. 
Their dispositions are naturally cheerful and joy- 
ous, unless sickl} r , neglected or mismanaged. The 
following remarks are well w T orthy the attention of 
mothers : 

The entire system of nursery discipline, too, has a direct 
tendency to call into action, at an early age, the passions of the 
child, rather than to still them, or direct them in their appropri- 
ate channels. At one time it is dandled and coaxed in order to 
quiet it ; at another it is scolded and beaten for the same purpose, 
We either do what it desires, or compel it to do what we like 
We comply with its whims, or make it submit to ours. 

Thus do medium is observed, and the child is doomed to be 
always giving orders or receiving them. Accordingly, the first 
ideas it forms are those of dominion or slavery; before it can 
speak it commands: before it acts it obeys; and sometimes it is 
corrected before it is conscious of faultSj or even before it is cap- 



208 PAINLESS CHILDBIRTH. 

able of committing any. We thus implant in its tender mind 
those passions which are afterwards unjustly attributed to 
nature; and having taking pains to render it depraved, we com- 
plain because we find it so. 

But a peevish and fretful disposition in infancy sometimes 
arises from too close confinement in stagnant and impure atmos- 
pheres, impairing the energies of the system, impeding diges- 
tion, and subjecting the sentient organs to impressions, if not 
positively painful, at least uncomfortable. The remedy consists 
in removing the cause. All attempts to prevent or soothe the 
fretfulness of an infant by cakes, sweet meats and confectionery 
should be prohibited. The child soon acquires a morbid appe- 
tite for such things, which is ruinous to its health, and it soon 
learns to cry and fret in order to obtain them ; nor should chil- 
dren when they happen to fall, or experience disappointment of 
any kind, be soothed by expressions of extreme pity and sorrow, 
and be allowed, in order to hush its cries, some foolish indul- 
gence. Nothing tends more certainly to encourage a fretful, 
complaining and exciting disposition, or to induce violent and 
long-continued paroxysms of crying for the most trifling causes. 

Fear of the most intense description, causing immediate in- 
jury to health and often producing a lamentable degree of fee- 
bleness of character in after life, is not URfrequently excited and 
cherished in children, by the reprehensible conduct of parents 
and nurses in attempting to render them quiet, or enforce their 
obedience to commands given them by threatening with a visit 
from some object of terror. As we are liable to be ruled often 
by the influence of incidents and impressions subject to revival 
by associations, when the causes which first produced them are 
remembered no longer, how studious, therefore, ought those who 
have the care of children to be, that no impressions be made on 
their minds which should bias their affections, mislead their 
judgments, or render migratory their best resolves to the end of 
their lives. We ought to be careful before punishing a child for 
obstinacy, that its fault really arises from its own wilfulness, and 
not from childishness or inability to do what you bid it. Inad- 
ventency, forgetfulness, unsteadiness and wandering of thought, 
are the natural faults of childhood, and, therefore, unless ob- 
served to be wilful, are to be mentioned softly > and gained upon 



K^ANAGEMENT AFTER BIRTH, 209 

by time. Children, if properly trained from their birth, are far 
more docile than the generality of parents are r inclined to be- 
lieve ; and, at a very early age can distinguish between what is 
reasonable and unjust in our behavior toward them. They 
should, therefore, be treated as rational creatures, and be made 
sensible by the mildness of our carriage, and by the composure 
even in our correcting them, that what is done is reasonable in 
us, and useful and necessary for them ; and that it is not out of 
caprice, passion or fancy, that they are commanded or forbidden 
anything. 

Anger is the most readily excited passion in childhood. Its 
immediate efforts are, in the highest degree, prejudicial to health, 
by determining to the head an undue amount of blood. It is 
very often the result of having frequently witnessed the exhibi- 
tion of violent passions in those who surround it. Crying, 
screaming and various gesticulations of the limbs and body, are 
the means by which the passions of anger and other violent 
emotions are generally expressed in infancy. 

Sometimes when a child begins to cry, to pacify it, a stick is 
offered it to beat the ' naughty stool' or 'stove,' that made it 
stumble ; with this the child may be quieted, but thence it in- 
stinctively acquires the disposition to revenge itself on whatever 
gives it uneasiness or inconvenience, whether things or persons ; 
and thus the desire for revenge is so deeply implanted in the 
mind as scarcely ever after to be entirely eradicated. Parents 
often truly wish their children to do well, but, by their own ex- 
ample, implant in their offspring the seeds of many a vice. 

There is another reprehensible custom, which, 
though perhaps not exactly a moral consideration, 
is not wholly inappropriate here, and that is, rock- 
ing or jolting the child every time it frets. Chil- 
dren can be taught to go to sleep just as well 
without rocking as with, and were I to bring up a 
score of children, none of them should be rocked. 
True, it often quiets them and induces sleep, but it 
does it by causing an abnormal condition of the 



210 PAINLESS CHILDBIRTH. 

brain and nervous system. Let a grown person 
try cradle rocking, or swinging, and see how they 
will like it. If motion is to be employed^ a carriage 
is far preferable. 

Frequently when the child is crying from colic, 
and its little abdomen is distended with wind, or 
when there may be determination of blood to the 
head, the head hot, feverish, and if the child could 
speak, it would add, painful, it is taken upon the 
knee and jolted, jounced and trotted, and the 
harder it cries the more vigorous the process, until 
it falls into an uneasy sleep. I always feel as if I 
want to horsewhip a mother or nurse who treats the 
suffering child in that way. Were they to try the 
same process w 7 hen suffering similarly to the child, 
they would ransack the vocabulary for words ex- 
pressive of condemnation. Often when attending 
children suffering with disease of the brain, I have 
more trouble to protect them from swinging and 
jolting than anything else — motions that are not 
only excruciatingly painful, but absolutely inju- 
rious. 

It is not possible within the scope of a work like 
this to introduce much pertaining to the remedial 
management of children, yet a few suggestions may 
not be out of place. A protest has already been 
made against indiscriminate dosing. 

Among the first things likely to demand atten- 
tion is the evacuation of the child's bowels. 
Usually the secretion in the mother's breasts will bo 



MANAGEMENT AFTER BIRTH. 211 

sufficient; and we may wait for twenty-four hours 
without interfering, If at the expiration of this 
time the bowels have not moved, give a tablespoon- 
ful of a moderately strong tea of elder flowers, 
sweetened with molasses. Repeat every two or 
three hours until the object is accomplished. A 
small dose of castor oil is often given with good 
results. 

New born infants are often afflicted with jaun- 
dice, which is easily recognized by the color of the 
skin, The elder flower tea alluded to above is usu- 
ally sufficient to overcome it if continued for a few 
days, but must not be given in large enough doses 
to purge. If the jaundice depends upon a diseased 
condition of the liver of an inflammatory char- 
acter, the skin and eyes will be of a dirty yellow, the 
stools clay-colored, the urine yellow and scanty, the 
child drowsy, with griping pains. I would advise 
in addition to the above measures that half a grain 
of leptandrin be triturated with five grains of sugar 
of milk, and given at a dose. This may be re- 
peated every four hours until the stool exhibits bil- 
ious matter. If the trouble does not yield quickly 
a physician had better be called. 

Usually the kidneys perform their func- 
tions naturally at birth, and if the child does 
not pass its water within ten or twelve hours, there 
will be more apt to be some obstruction to the flow, 
than a lack of secretion. Observe carefully that it 
has not urinated. If the urine is retained and the 



212 PL All? ESS CHILDBIRTH. 

bladder fall, it may be felt as a round, circumscribed 
tumor in the lower part of the abdomen. If such 
be the case a physician is to be called at once, who 
will introduce a catheter, or bougie, for the child's 
relief, unless some other expedient he may suggest 
avails. If there is no urine secreted, then a few 
drops of sweet spirits of nitre in water may be 
given. Before resorting to medicine a correct diag- 
nosis should be made, for if the bladder is full and 
nitre is given it may increase the trouble. 

Three or four days after birth, infants are often 
attacked by a peculiar species of inflammation 
of the eyes, which should receive immediate at- 
tention, for delay here is especially dangerous and 
may result in destruction of sight, while if promptly 
and properly treated will generally yield with little 
trouble. The causes may be matters of an irritat- 
ing character from the mother getting into them at 
birth, cold, exposure to bright light, or soap suds 
getting into the eyes when washing it. A physi- 
cian should be called at once, though a tea of cham- 
omile flowers to bathe the eyes is often beneficial. I 
have found the following very satisfactory ; 

Permanganate of Potash, . . 2 grains. 
Pure Water, .... 4 ounces. 
Mix. — Bathe the eyes often with it, taking care to get some of 
it into the eyes. 

Borax, . . . . . .5 grains. 

Rose Water, . . . . 1 ounce. 

Mix. 



MANAGEMENT AFTER BIRTH. 213 

The latter is also an excellent mixture, and may 
be freely used. Wash the eyes with pure warm 
milk and water and remove all crusts and secre- 
tions, and to prevent the lids sticking together, 
apply a little pure olive oil, or a dram of pure glyc- 
erine may be added to the borax and rose water for 
the purpose, and will usually be found to work well. 
The eyes are to be protected from the light. The 
bowels must be kept gently open until the inflam- 
mation subsides. 

In the purulent opthalmia of infants no time is 
to be lost or the eyes may be destroyed. The dis- 
charge is profuse and mattery, the lining mem- 
brane very red and swollen, light unbearable. 
Absolute cleanliness is needed. Thoroughly bathe 
eye several times a day with : 

Boracic Acid, .... 1 dram, 
Hot Water, 4 ounces. 

Use warm, taking care to thoroughly cleanse the eye, and be 
careful that no matter be transferred to the other eye. 

A competent physician should attend the case. 

Vomiting must not always be regarded as an 
evidence o disease, for many healthy children 
vomit. Indeed, it must be regarded as a wise pro- 
vision of nature for the disposal of an excess of 
food. When this is the case, care should be exer- 
cised to diminish the quantity of food taken. 
Vomiting may, however, be caused by an unhealthy 
condition of the milk; it is also the result of irrita- 



214 PAINLESS CHILDBIRTH 

tion of the stomach, and when due to this latter 
cause the child soon becomes pale, feeble, distressed 
looking, and loses its appetite. 

The remedies mostly to be depended upon in 
these conditions are to be derived from the home- 
opathic school, and are aconite, arsenicum, ipecac, 
nux vomica and pulsatilla. A drop of the tincture 
of either may be put into a glass half full of water, 
of which a teaspoonful is to be given every three or 
four hours. Preparations of pepsin are much em 
ployed for the purpose, and for an infant of a few 
months, one grain of pepsin and one-fourth grain 
of subnitrate of bismuth may be given every three 
or four hours with advantage, thus : 

Pepsin, 4 grains, 

Subnitrate of Bismuth, , . .1 grain. 
Make four does. One every three hours. 

Derangement of digestion, over feeding, 

disease of the mother, impure milk and a variety 
of circumstances render infants liable to a loose- 
ness of the bowels. The cause should be carefully 
sought and remedied, for nothing is more damag- 
ing to infants than the disorders of the stomach 
and bowels. The prescription just given is excel- 
lent and will generally correct the stomach and 
through it the bowels. The addition of a table- 
spoonful of lime water to a pint of milk will in many 
instances arrest the trouble. All indigestible arti- 
cles of food must be carefully prohibited- Often 



MAXAGEMEKT AFTER BTPSK 215 

oily matters are the cause, and by skimming the 
milk it may be taken without further trouble. Opi- 
ates are too often resorted to, but they merely 
check the trouble for the time being, only to break 
out again when the remedy is suspended. I have 
found the homeopathic remedies — arsenicum, 
chamomilla, camphor, ipecac, mercurius, podophyl- 
lum, and iiux — usually adequate for the relief of 
such cases w r hen associated with regulation diet. 
One or two drops of the tincture may be added to 
half a glass of water and a teaspoonful given every 
two or three hours. Probably the podophyllum 
will be oftenest suitable, 

Very small doses of the neutralizing cordial of 
the eclectic school repeated every three or four 
hours, will generally correct the trouble. That 
prepared with brandy and not much sugar is best, 
and may be given in ten or fifteen drop doses to a 
child three months old. Alternate it with the pep- 
sin and bismuth. 

Colic is one of the approbia of infancy, and 
may depend upon flatulency, or upon impaired di- 
gestion, acidity, etc. When upon acidity a little 
soda is the most ready remedy, and may be added 
to the milk. The stools in this case will generally 
be green, and the matter vomited sour, the child 
worrisome. When from impaired digestion, care- 
ful regulation of the diet, and nux vomica as under 
the head of vomiting. When due to flatulence a 
little camphor sling, tea of fennel seed, sweet flag 



216 PAiisriBsa cihldmbte. 

celery, chamomile, etc. I have however, found 
colocynth one of the grand remedies for infantile 
colic. It may be given as prepared and found in 
the homeopathic medicine cases, or this : 

Tincture of Colocynth, . . 2 drops. 

Water, .... .2 ounces. 

Dose — A teaspoonful every hour. 

One dose will usually suffice, and by repeating it 
once in four or five hours the tendency to colic is 
often broken up. 

When the trouble is repeated often, an occasional 
dose of the neutralizing cordial may be given and 
then alternate colocynth with carbo vegetabilis of the 
homeopaths, two to four hours apart till the malady 
is wholly broken up. Careful attention to diet is 
necessary. 

The formation of bone, as may be inferred by 
reading the preceding chapters, requires the food to 
contain more or less of lime. As our dietetic meas- 
ures deprive the infant of this element during its 
foetal existance the question arises, may not this 
element be so deficient as to retard the natural de- 
velopment of bone, teeth, etc., after birth ? Such 
a condition is not likely because the food of the 
mother, milk, etc., contain this substance in suffi- 
cient quantity for the purpose of the system, and it 
is often administered in 'the form of lime water in 
milk. When the child manifests the symptoms of 
teething, and still the teeth delay, I have often 



MANAGEMENT AFTER BIET3. 217 

given some of the preparations of lime with speedy 
results. The homeopathic school recommends the 
carbonate, or as they term it, calcarea carb, It is 
an effective preparation and will give satisfaction. 
The process of teething is very often accom- 
panied by derangement of the bowels, and we are 
to be careful how we abruptly check a diarrhoea at 
the time lest we cause an irritation of the brain and 
nervous system of far more serious tendencies than 
the diarrhoea. Usually the gums will be swollen, 
hot and painful. Frequently bathing the mouth of 
the child, cooling drinks, etc., will be beneficial, 
and at the same time if there is diarrhoea lime 
water should be added to the milk. If the diarrhoea 
becomes too profuse employ the remedies as directed 
under diarrhoea. If there are symptoms of dis- 
turbance of the brain, control with gelsemmum. 
This will be better than opiates, thus : 

Fluid Extract of Gelseminum.. . . 2 drops. 

Water, . . . . . .2 ounces. 

Dose — A teaspoonf ul every one or two hours. 

If there is fever, add aconite to it, thus : 

Fluid Extract of Gelseminum, . . 2 drops. 
Tincture Aconite, .... 2 drops. 

Water, 2 ounces. 

Dose — One teaspoonf ul every one or two hours. 

The child should have something to bite on at 
the same time to aid in bringing the teeth through. 
I have found such a course satisfactory in nearly 
all cases. 



218 PAINLESS CHILDBIRTH 



CHAPTER XL 



STERILITY. 

A Divine Mandate — The Consummation of Love but Half At- 
tained — Professional Confidences — Quacks and Marriage 
Guides — Interesting Considerations — History— Causes of 
Sterility — Hymen — What its Presence or Absence Indicates 
— The Woman Blamed— -Displacements of the Uterus — Uter- 
ine Tumors— How they .Act as Causes and who are to Man- 
age them— Deformities of the Uterus — Stricture — Chronic 
Inflammation— Leuchorrhoea— Dysmenorrhea — Menstrual 
Derangements — Ovarian and Uterine Debility — Sexual Ex- 
cesses and Apathy — Ovarian Diseases — Late Marriages — ■ 
Sometimes the Husband is to Blame if Marriage is Unfruit- 
ful — Temperamental Incompatibility — Other Causes — Some 
not to be Considered — Relations of Society — When a Woman 
is Sterile who is to Blame. 

In obedience to a Divine mandate, it is natural 
for woman to yearn for motherhood, for it is 

the ideal state of every woman who has not already- 
arrived there. Although it is not uncommon to 
meet young married women who wish to defer the 
assumption of maternal responsibilities for a time, 
there are few women indeed who will voluntarily 
pursue life's journey without the companionship of 
one or more of those little blessings, to enliven her 
sympathies and increase her enjoyment in the 
noonday of life and to comfort her declining years. 



STERILITY. 219 

Marriage is the consummation of love ; yet 

without offspring its object is but half attained. 
The coming of children strengthens the ties already- 
existing between man and wife, and renders happy 
and harmonious lives that would otherwise be 
passed in estrangement and discord. 

The yearning of the wife's heart for children is a 
natural instinct that is largely shared by the hus- 
band. Although they may conceal their desires 
from one another, and even publicly assert that they 
entertain an intense hatred for children, in the 
privacy of the professional consultation, confessions 

are made which prove that nature is true to herself. 

% 
With, many females the grave is looked forward to with more 
cheerfulness than a childless longevity, and not a few husbands 
would rather die in the prime of manhood and leave an heir, 
than to live to gray -old age and be considered incapable of re- 
production. 

So great is the regard of offspring by both 
husband and wife (and I do not consider it a be- 
trayal of professional confidence, when I assert that 
I am very often consulted on the subject either in 
person or by letter), the question is often asked by 
both male and female, " Am I capable of becoming 
a parent ?" and when disappointed in the realiza- 
tion of their desires, though perhaps charging the 
fault upon the other, they secretly and without the 
knowledge of the other, seek professional ad 
vice and remedy. In other cases both parties seek 
advice together, hoping by so doing that the true 



$20 PAHTLESS CHILDBIRTH, 

cause of the barrenness may be ascertained, and 
the proper remedy obtained. I 

There are very few subjects that give men ; 
or women more anxiety than this, for to go 

through life with the self consciousness of procrea- 
tive inability, is indeed a source of very great un- 
happiness. Quacks have taken advantage of this 
and made the subject the basis of numerous '" Mar- 
riage Guides," in which the authors have sought to 
impress the unmarried with a belief in their own 
incompetency in order to wring from them large 
sums of money for pretended restoration. 

According to the observations made by English 
investigators nearly one married woman in eight is 
barren. Barrenness, however, cannot be consid- 
ered as absolute, even without interference, for it is 
known that women who have borne children may 
become sterile, while on the other hand, women 
who have been sterile for years subsequently become 
fertile. It has not, however, transpired in the course 
of these investigations how far the sterility may be 
the fault of the husband. Nor is it likely that such 
an inquiry can ever receive more than an approxi- 
mate answer, for the very reason that people will 
never consent to have their private matters become 
public property to the extent necessary to form a 
close estimate, based upon statistics. 

Having made chronic diseases of the reproduc- 
tive functions of both sexes a specialty for years, I 
trust I may be pardoned for saying that the subject 



STMMTLITT. 221 

of procreation concerns gentlemen far more than is 
generally supposed. 

In connection with the subject of sterility, it 
may not be any breach of professional confidence, 
when I say, that the extensive prevalence of sexual 
abuses, and excesses of the young, and even of the 
middle aged, render them liable to certain disorders 
which so intimately concern the married state, that 
I am consulted daily either in person or by letter, 
by both sexes, as to the propriety of marriage. I 
mention the matter here to illustrate the causes of 
sterility, as being sometimes the husband's fault, for 
which the wife is generally blamed. If the male 
party to a marriage contract has by vices and per- 
nicious practices despoiled his manhood and finds 
the union unhappy, or unproductive in consequence, 
it is fully as proper that he seek professional assist- 
ance as for the wife to bear the odium of barren- 
ness. Happily I am able to offer those who consult 
me in these matter very decided assistance, these 
disabilities being for the most part amenable to 
proper treatment 

The average time elapsing between marriage and 
the first child is about seventeen months. The first 
three years may be permitted to lapse before the 
woman can practically consider herself sterile, 
though if she has not made use of any preventives 
during that length of time, and conception has not 
occurred, the chances are as thirteen to one against 



222 PAINLESS CHILDBIRTH. 

her, for she will be likely to remain unfruitful, ex- 
cept she receive assistance from art. . 

In considering this subject, it is to be remembered 
that it does not always follow because a marriage is 
fruitless, the wife is to blame ; nor does it follow 
because a woman has not borne living children, that 
she is always sterile ; nor is it certain that if she is 
barren the first few years of married life, that she 
will never have children. Women sometimes be- 
comes fecund after years of sterility. The mother 
of Louis XIV. was sterile for twenty-two years be- 
fore his birth ; the wife of Henry II. became the 
mother of ten children after a period of ten years 
of barrenness. Dr. Tilt, of England, mentions a 
case of a healthy woman who had married a healthy 
man at eighteen, but did not bear a child until she 
was forty-eight Numerous instances are on record 
where a marriage has been unproductive, divorce 
followed with subsequent marriage of the man and 
wife to another woman and man, respectively, and 
the subsequent unions were blessed with offspring. 

The causes of sterility are various, and in a 
very large per cent, of cases can be remedied. A 
careful investigation of each individual case will 
usually reveal the cause of sterility, so that I can 
point out the indications of cure. 

Among the causes most frequently met are the 
following : 

Chronic inflammation of the neck or body of the 
womb, stricture of the neck of the womb, flexure or 



STERILITY. 223 

elongation of the neck of the womb, tumors, 
growths, polypi, or other obstructions of the neck of 
the womb, displacements, uterine tumors, ovarian 
diseases, profuee and acrid vaginal secretions, uter- 
ine catarrh, leucorrhoea, imperforate hymen, sexual 
excesses, uterine and ovarian debility, membrane- 
ous dysmenorrhea, menstrual derangements, sexual 
frigidity, nursing, late marriages, disease of husband 
causing imperfect development of spermatozoa, 
temperamental incompatibility, imperfect develop- 
ment of the womb and ovaries, displacement of the 
ovaries, stricture of the fallopian tubes, adhesion of 
the fimbriated extremity of the fallopian tubes, 
etc., etc. 

From this list of causes it will be readily inferred 
that with the exception of the last three or four, all 
are amenable to treatment when properly under- 
stood, because they are dependent upon conditions 
which the best authorities of the present unite in 
declaring curable. / 

Formerly, the causes of sterility were shrouded in 
mystery, and the treatment speculative and empiri- 
cal, but light has been let in upon the subject by 
modern investigators, and barrenness is now known 
to be occasioned by certain conditions capable of 
removal. Much of what is known of the diagnosis 
and treatment is due to the labors of Drs. Sims, 
Thomas, Emmet and a few others, who have 
stripped the subject of its mystery and made the 



224 PAINLESS CHILDBIRTH. 

treatment more than a mere matter of conjecture 
and guess work. 

It will be seen that a very large per cent of these 
causes act in a purely mechanical manner, 

by preventing the entrance of the spermatozoa into 
the womb or beyond it, where it may, by uniting 
with the germ cell, occasion conception. Numer- 
ous theories have been advanced as to the manner 
in which conception takes place. 

It is now understood that the sperm cell of the 
male and the germ of the female must come in con- 
tact before it can occur, and that this union must 
occur beyond the mouth of the uterus, and under 
certain conditions. How these cells influence each 
other is not at present definitely known, but upon 
their union the germ acquires a disposition to unite 
itself to some tissue from which it may receive 
nourishment and support. The tissue which is 
most favorable for this purpose is the lining of the 
cavity of the womb, though it sometimes occurs in 
the fallopian tubes or at the ovary. 

The cavity of the uterus appears to be the most 
favorably designed for the reception, protection and 
development of the fecundated germ, and the ques- 
tion seems settled that the sperm cell — the sperm- 
atozoon — must penetrate the reproductive passages 
of the female as far as this cavity, or fecundation 
can not take place. So far as I have been able to 
ascertain, no instances are reeor Jed where concep- 



STERILITY. 225 

tion has tiken place between tbo cavity of tjifi 
uterus and the externa] generative organs, 

So far as the penetration of spermatozoa to the 
cavity of the uterus is concerned, it is entirely me- 
chanical and may occur without the female experi- 
encing any of the sensations due to the generative 
act whatever, although recent developments show 
beyond a doubt such experience on her part favors 
such penetration- 
Instances have been known in which the sperm- 
atozoa have penetrated the uterine cavity and 
passed through the fallopian tubes to the ovary, but 
it is not satisfactorily determined that it must 
always be so in order that conception occur. After 
the union of these two infinitesimal cells has taken 
place, certain other favorable conditions are neces- 
sary to their development, and it is upon these con- 
ditions that the success of the impregnation 
depends. If the sperm cells are unhealthy or im- 
perfectly developed, although the maternal parts 
are prepared for their reception, their death instead 
of their development will occur, If the interior 
of the womb is in an unhealthy condition, the 
fecundated germ may be unable to effect its adhe- 
sion and consequently be thrown off. 

Recent authors claim that a catarrhal condi- 
tion of the lining membrane of the womb is to a 
very great extent to blame for all the cases of ster- 
ility not due to mechanical obstruction. Chronic 
inflammation of the mucous membrane will always 



226 PLAINESS CHILDBIRTH. 

be associated with a catarrhal discharge. The 
membrane being bathed in a secretion of its own 
mucus, while it may not destroy the germs by 
any poisonous qualities, prevents their lodgement 
and nutrition, and thus effectually prevents con- 
ception. If the ovaries are diseased, the germ 
cells may not be able to maintain life and perform 
their part. Thus failure may be due to some defect 
in the sperm cell, in the germ cell, or in the condi- 
tion of the uterus. 

In addition, the disciples of the electro-mag- 
netic and the temperamental doctrines, would 
have us believe that the failure may be due to defect- 
ive magnetic conditions, temperamental incompat- 
ibilities, etc , which, perhaps, even they themselves 
cannot clearly explain. 

Among the causes of sterility, doubtless the most 
important are those which oppose the entrance of 
the spermatozoa into the uterine cavity where con- 
ception can take place; these are anything that 
obstructs the uterine canal, and may exist before a 
child has been born, or may be acquired afterward ; 
thus, imperforate hymen, displacements, tumors, 
polypi, granulations or other growths within the 
neck of the womb, angular curvature of the uterine 
neck, stricture of the same, and chronic inflamma- 
tion, to which might be added technically, occlu- 
sion of the mouth of the womb. 

Imperforate hymen, as anyone who will 
consult a work on anatomy will readily see, neces- 



STERILITY. 227 

sarily prevents, the entrance of the spermatozoa ; 
indeed, it does not permit them to even reach the 
mouth of the womb at all. At one time the hymen 
was considered as the test of virginity, but thanks 
to the enlightenment of the present, it is no longer 
so. There are many ways in w T hich this membrane 
may be ruptured without in the least compromising 
the virginity of the female. It may be ruptured 
by the use of a female syringe w T hich every female 
who respects cleanliness will use, occasionally at 
least. It may be so fragile as to be ruptured by the 
menstrual flow, and in other ways ; while on the 
other hand, it may be so powerfully developed that 
all attempts at copulation will be futile. There may 
be a small orifice through which the memses may 
escape, and through which it is possible the sperm- 
atozoa may enter, but not probable When this is 
the case, nothing short of a surgical operation will 
suffice for its removal. 

On the one hand the woman is blamed if this 
exceedingly uncertian test of chastity does not exist, 
and on the other she will be blamed for the sterility 
its excessive development occasions. In the first 
place, none but the ignorant, prejudiced and exact- 
ing will be disappointed if it does not exist. In the 
second, a professional consultation will allay any 
unhappiness and anxiety. Let our readers bear in 
mind that in medical jurisprudence the presence of 
this membrane is not an absolute proof of chastity, 
nor does its absence prove immorality. 



228 PAINLESS CHILDBIRTH. 

Uterine displacements may occasion ster- 
ility. The manner in which they operate is either 
to turn the mouth of the uterus in such a direction 
that the spermatozoa cannot reach it, which might 
be the case in anteversion, a displacemenet in which 
the body of the uterus is tipped forward and down- 
ward, and the neck and mouth carried upward and 
backward, the central attachment acting as a pivot 
upon the which uterus very nearly turns bottom up 
ward by tipping forward. This condition is usually 
associated with more or less trouble with the bladder, 
and is exceedingly difficult to cure, mechanical 
means being usually essential to success. In retrover- 
sion the uterus tips backward instead of forward, the 
body of the organ falling backward into the hollow of 
the sacrum, while its mouth is carried forward and 
upward behind the bladder, turning the mouth per- 
sistently away from the spermatozoa. By the press- 
ure of the uterus in this condition upon the lower 
bowel, constipation and backache are occasioned. 
This form of displacement is more frequently met 
than anteversion. It may be cured by mechanical 
measures to overcome the mal-position, and the 
employment of remedial agents to so tone its sup- 
ports that the natural position may be maintained. 
Very often this displacement is associated with an 
enlargement and increase in weight of the organ 
which must be overcome before a permanent cure 
can be expected. These mal-positions very often 
result in sterility. 



STERILITY. 229 

Another form of displacement known as prolap- 
sus or falling of the womb, is often a cause of barren- 
ness. In such cases the mouth of the uterus often 
rests upon the floor of the pelvis and is buried in 
the soft tissues covering the perineum or vaginal 
walls, which form as it were by the pressure, a com- 
plete covering for the mouth of the womb, prevent- 
ing the entrance of anything. To overcome this 
trouble has taxed the ingenuity of the profession 
for years, In such cases there are a great variety 
of symptoms, sympathetic disturbance, etc. The 
indications of cure are to reduce the increased 
weight of the organ, replace it, and by increasing 
the power of its supports or otherwise maintain the 
proper position. This is often difficult to do, and 
we often hear a physician saying, "If you could 
only have a child it would cure you." The truth 
of it is, if they could only cure the patient she would 
be very apt to have a child. We cannot in the 
space allowed this subject consider the methods of 
cure, nor would many be likely to succeed without 
professional assistance. Artificial supporters are 
necessary in many cases, while in others they make 
the troube worse, and are so painful that no woman 
can wear them. 

Tumors, growths, etc., when occurring in the 
uterine neck, form a mechanical obstruction to the 
entrance of the spermatozoa, and as conception can- 
not occur in the vagina, they become efficient 
causes of sterility. By blocking up the canal of the 



230 PAINLESS CHILDBIRTH. 

uterus they interfere with the escape of the men 
strual flow, causing severe pain at the menstrual 
period, and by modifying this function are often 
the cause of profuse hemorrhage. A careful exam- 
ination is necessary in order to correctly diagnose 
the nature of the trouble. On the introduction of 
a speculum the trouble may be at once apparent, or 
it may require the dilatation of the uterine mouth 
and neck before the source of troube becomes visi- 
ble. Very often the morbid growth will be so small 
as to escape notice, yet it is a very efficient source 
of trouble. The growths most frequently met with 
are granulations, or polypi, though tumors may be 
present. 

The measures to be employed for their removal 
necessarily vary with the nature of the growth, 
size, location, etc, etc. Granulations and small 
polypi, will usually disappear when pressure is ap- 
plied continuously for a time and for this purpose 
sponge tents are used; medicated or otherwise, as 
may be. Caustics are frequently used, but when 
either measure is employed it must be by the direc- 
tion of a skillful physician. Large polypi may be 
removed by forceps, snare, ligature, or scissors. 
Hemorrhage may be troublesome, but usually in 
the hands of one who understands his business there 
will be little trouble or pain in their removal. The 
removal of tumors may be effected with a knife, 
ligature, caustic, injection or electricity. No one 
but a skillful surgeon has any business to touch 



STERILITY* 231 

them. When either of these troubles have caused 
sterility their removal will be likely to be followed 
by conception. 

It may be proper to place in this division another 
form of abnormal development that is some- 
times met, as a cause of barrenness : it is when the 
posterior lip of the uterine mouth is unnaturally 
long and folds over the entrance of the womb like 
a valve, forming an effectual barrier against the 
entrance of anything into the womb, but is no im- 
pediment to the escape of the menstrual flow. 
Such a condition might pass entirely unnoticed be- 
cause it would not be attended by any other 
troubles that would be likely to lead to its recogni- 
tion, and unless the female came under examina- 
tion to ascertain the cause of her sterility, it would 
probably never be known, and even then unless the 
examiner was on his guard it might easily escape 
detection. This cause can be easily remedied by a 
surgical operation. 

Curvature of the neck of the womb, is a 
fruitful cause of sterility, and is a frequent source 
of painful menstruation. The body of the womb 
may be bent upon its neck in such a manner as to 
obstruct the canal sufficiently to prevent the en- 
trance of spermatozoa, or exit of menstrual matters, 
in the same way that a finger of a glove may be 
bent as to prevent the passage of even water. The 
curvature may be so great that the axes of the neck 
and body of the womb will intersect at nearly right 



232 PA1XLESS CHILDBIRTH. 

angles. Take a hollow tube and bend it upon itself 
to a right angle, or even an obtuse angle, and you 
have a good illustration. When the curvature is 
forward, it is called " ante-flexion " if backward, 
° retro-flexion " if sideways, " lateral-curvature ? 
These deviations from normal position, are often 
more easily recognized than cured. 

Several forms of treatment are in vogue, one of 
which is to cut or divide one side of the neck, be- 
fore or behind according to the flexion, in order to 
establish a straight and free passage. When prop- 
erly performed, it is generally successful; it is not 
very painful, though there may be some hemor- 
rhage: The subsequent treatment must be thor- 
ough or the divided portions may unite and leave 
it worse than before. Another plan is to dilate the 
neck of the womb and introduce an instrument 
that will hold it straight, until the curvature is 
effectually overcome. Uterine supporters are also 
employed, but the surgical treatment is by far the 
most successful, though the dislike many entertain 
for the knife will often lead to a trial of the other 
measures. Many cases are recorded in which the 
successful treatment of curvature by one or the other 
of these methods has been followed by a realization 
of the highest hopes — a child ! 

Stricture causes sterility in a manner very 
similar to curvature, the uterine canal being nar- 
rowed by constriction so as to prevent the easy pas- 
sage of the menses from within, or spermatozoa from 



steeiltit: 233 

without. An examination by the touch, or by spec- 
ulum, will often reveal nothing ; but when an 
attempt is made to introduce a uterine sound, the 
trouble becomes apparent. This trouble is there- 
fore very often overlooked, and the sterility attrib- 
uted to other causes. There is very little excuse 
however, for overlooking this condition, when a 
thorough investigation is being made. 

The treatment of this difficulty consists in per- 
manently enlarging the canal, which may be done 
by the use of tents, or bougies, or by a single or 
double incision. The use of tents rarely effects 
permanent dilation, for the uterus has a tendency 
to return to its previous condition after their use 
has been discontinued. Bougies are more success- 
ful if properly used, and may be retained in posi 
tion much longer than tents, but the incision, 
performed in much the same manner as for curva- 
ture, and properly attended until the incised surface 
has healed up, is almost always successful, and oc- 
casions little pain though the woman must remain 
in bed a few days. There are few cases but that re- 
main permanent if the operation has been made 
with the requisite amount of skill. The perform- 
ance of this operation, and the frequency with 
which it has been followed by conception, as well as 
relief from the most intense sufferings at the men- 
strual period, reflects very great credit upon the 
name of Dr. J. Marion Sims. 

Elongation of the nock of tlie womb is also 



234 PAINLESS CHILDBIRTH 

a source of barrenness and painful menstruation, 
and its successful amputation his been effected. 
When the neck is unusually long, there is generally 
a corresponding narrowness, and the treatment is 
made for the purpose of enlarging the canal to 
facilitate the passage of the spermatozoa. It makes 
little difference in the result which of the three op- 
erations, as for stricture, are made, if properly per 
formed, but of course skill will be necessary, and 
no one must attempt it without a clear understand- 
ing and the requisite facilities. 

Occlusion, by which a complete closure of the 
neck of the womb is meant, may be due to congen- 
ital malformation, or to ulceration, which in heal- 
ing has resulted in uniting the edges in such a 
manner as to completely obliterate the canal. The 
improper use of caustics may also produce this re- 
sult, and there can nothing enter the uterus nor 
escape from its cavity. Such a condition will be 
far more likely to demand interference on account 
of the trouble arising from the retention of the 
menstrual discharge, than for the relief of sterility. 
The establishment of an artificial opening by sur- 
gical means is necessary and gives speedy relief 
Such cases are rare. 

Chronic inflammation may be confined to the 
neck of the womb, to the body, or to both, and may 
involve only the mucus membrane lining or ex- 
tend to deeper structures. It is a frequent affliction 
of civilized women, and on account of its frequency 



STERILITY. 235 

becomes one of the fruitful causes of barrenness. 
An endless variety of symptoms accompany this 
ailment, which are not only referred to the repro 
ductive organs, but, through sympathy, may extend 
to every part of the body. This ailment is not an 
absolute preventive of conception, but it is not very 
probable that the woman that is afflicted with it 
will bear children. 

In this trouble the neck of the womb may be 
much larger than natural and the membrane very 
much relaxed ; but there will be formed in the neck 
a plug of thick tenacious mucus, so completely fill- 
ing the canal that it opposes a mechanical barrier to 
the entrance of the spermatozoa. When this is not 
the case it will be so acid as to destroy the vital- 
ity of the spermatozoa, and the sterility is as certain 
as if they did not reach the locality at all. I have 
known many physicians to fall into error in the 
matter, because they were misled about the possi- 
bility of the mechanical impediment when the 
canal was so much larger than normal. 

A cure of this ailment is essential to the fruitful- 
ness of the female, and can be effected by a proper 
and persistent course of treatment, but to give a 
course of treatment so that it would be available, 
would require more space than is at our present 
disposal, and the patient is referred to works on the 
subject. Constitutional treatment alone will not 
always be successful, and local measures are often 
demanded. The internal employment of the squaw 



236 PAINLESS CHILDBIRTH 

vine and black cohosh, already mentioned, may 
succeed, and are worth a trial. Their effect may be 
aided by injections, more particularly for cleanli- 
ness, and the use of pieces of cotton batting, satu- 
rated with glycerine and placed against the neck of 
the womb. The action of the glycerine is to set up 
a drainage of tne watery elements of blood con- 
tained in the minute blood vessels of the uterine 
neck, and thus relieve the turgescence and stagna- 
tion. They are to be repeated daily or at least 
every other day for a considerable time, but omitted 
at menstruation, Medicating the glycerine with 
one-eight part of tincture of iodine, golden seal, 
calendula, etc /sometimes increases the efficacy. 

It is scarcely necessary to allude to malforma- 
tions or anatomical defects, other than those already 
considered, for the public are aware of their influ- 
ence on fecundity. Some may, however, be reme- 
died by surgical ■ means, and we would urge all 
women whose happiness depends upon their ana- 
tomical perfection not to be discouraged until they 
have consulted some good surgeon. It would be 
the part of wisdom, however, when a mal-forma- 
tion exists not to enter matrimony until a surgeon 
has been consulted. 

The foregoing causes of sterility are me- 
chanical in their operation, and the removal of 
the cause by medical or surgical means will usually 
be followed by relief of the maternal disab?ility. 
Should the sterility continue more than two years 



STERILITY. 237 

after the removal of any of the causes already con- 
sidered, some other cause will have to be sought, 
among which the most frequent are the following : 

Acrid vaginal discharges, membraneous dysmen- 
orrhea, menstrual derangements, uterine and ova- 
rian debility, sexual excesses, sexual apathy, ovarian 
disease, late marriages, imperfect development of 
ovaries, displacement of ovaries, stricture of fallo- 
pian tubes, temperamental incompatibility, disease 
of husband, nursing, etc., etc. 

Acrid vaginal discharges prevent conception 
by destroying the spermatozoa before they reach the 
germ cell. Usually this trouble will be considered as 
leucorrhcea and properly enough so, yet experts as- 
sure us that some forms of leucorrhoea, or " whites/' 
do not cause barrenness, while others do. Facts of 
the kind are within the knowledge of nearly every 
observing person. The leucorrhoeal secretion is not 
always the same but admits of a great variety of 
modifications, and some forms are so very acid that 
they are as destructive to cell life as a solution pre- 
pared in the laboratory of a chemist could be. In 
such cases, particularly if long continued, there will 
usually be soreness of the parts caused by the cor- 
rosive character of this discharge. 

While a cure is always desirable it is not always 
so easily effected. A lotion of permanganate of 
potash, ten grains in a pint of water, used freely, is 
very valuable ; still there may be constitutional 
troubles on which the discharge depends, that will 



2S8 PAINLESS CiriLBBIIlTff. 

need attention as well as the local trouble. The 
sepia of the homeopathic school I have found ex- 
ceedingly valuable, in such cases, as an internal 
remedy. Locally, a great variety of remedies have 
been employed, but as it is only as a cause of ster- 
ility we are considering it, we may say that if the 
spermatozoa can escape the deadly influence of this 
secretion and enter the uterus, conception may be 
effected. The use of injections before the sexual 
act, to remove as much as possible of this secretion, 
will increase the probability of success, and if after 
the use of an injection of warm water, which is 
made for the purpose of cleanliness, an injection of 
milk is used the probabilities of success are en- 
hanced, the object being to protect the male element 
in its passage to the womb by removing the vagi- 
nal secretions, or by rendering them harmless. 

Membraneous dysmenorrhea is that form 
of painful menstruation in which the flow is ex- 
pelled with shreds of tough membrane, or perhaps 
with complete casts of the interior of the uterus. 
Although it does not always cause barrenness, it is 
likely to do so. Its pathology is not well under- 
stood. It causes sterility by preventing the united 
sperm and germ cells from securing an attachment 
to the walls of the uterus so that development can 
occur, or carries them away with it when it is ex- 
pelled. It is difficult to cure. When conception 
does occur it must take place soon after menstrua- 
tion. It may exist in the single. When the dis- 



STERILITY. 239 

ease is removed, among the married, pregnancy- 
results. It has been thought that pregnancy would 
cure it, but instances have come to knowledge 
where the women had borne more than one child 
and still did not get relief from this trouble. 

Menstrual derangements usually cause ster- 
ility, particularly when the flow is profuse, by 
washing away the impregnated ovum. When 
there is menstrual derangement, a functional dis- 
ease of the womb or a disease of the ovary is apt to 
co-exist, which may prevent the perfect develop- 
ment of the germ cells and thus cause the union of 
the male and female ^elements to be futile. The 
use of the squaw vine will be found of great value 
in these cases. Rectify the derangement and preg- 
nancy may then occur. There is a plant known as 
senecio aureus, or life root, which may be used with 
the squaw vine in infusion or syrup. Sometimes 
the derangement results from a low grade of vital- 
ity on the part of the woman, and when such is the 
case the preparations of iron are of value. If from 
congestion, with dragging down, aching, etc., the use 
of small doses of belladonna may so far overcome 
it as to favor conception. Fifteen drops of the 
homeopathic tincture in four ounces of water, and 
a teaspoonful taken every four or five hours, often 
succeeds in overcoming this latter condition. 

Uterine and ovarian debility causes sterility 
by imperfectly developing the germ cells or by im- 
perfectly nourishing them after they are fecundated. 



240 PAINLESS C3ILDBIHTE. 

Where there is no constitutional debility we may 
attribute the sterility to purely local debility or 
inertia. In case there is constitutional debility a 
course of tonics are proper. Iron, squaw vine, life 
root, quinine, nux vomica, etc, in proper doses, will 
often be followed by the -desired results. In case of 
a purely local inertia or debility the use of elec- 
tricity, passing the current through the body from 
the lower part of the back to the point over the 
pubes, may succeed. The use of an electrical cur- 
rent passed into the uterus by one pole of the bat- 
tery being introduced into it, the other over the 
back, is sometimes successful, and so is the applica- 
tion of a strong child to her breasts. There is a 
sympathy between the breasts, and womb and ova- 
ries, and by the reflex influence the natural func- 
tion is so acted upon that conception at that time 
may be effected. 

Sexual excesses exhaust the vitality of both 
parties to such an extent that the germ and sperm 
cells may not be sufficiently viable to perform their 
part in reproduction. By a wise provision of na- 
ture, such devitalized elements are frequently un- 
productive, and it is well that it is so. The remedy 
lies in modifying the indulgences to a frequency 
consistent with vitality, correcting the debility with 
a judicious course of tonic medicines, and, if nec- 
essary, such a course of local treatment as has been 
advised under the preceding section — electricity, 
culd bathing, sea bathing, etc. 



STERILITY. 241 

Saxual apathy, while not an absolute cause of 
p erility, may properly be considered as one of them. 
Many women bear children who do not experience 
the least sexual desire ; yet others are barren on 
that account. When such is the case, an inquiry 
into the causes of the sexual apathy is necessary, 
and the case treated according to such indications 
as may be rendered apparent by the investigation. 
The fact that sterility is not always caused by the 
absence of sexual senses, leads us to the presump- 
tion that it is only in certain forms of this condi- 
tion that sterility results, consequently the course of 
treatment selected will have to be dependent upon 
the cause. The use of tonics, electricity, injections 
of stimulating substances, as ammonia, (weak,) 
tincture of myrrh, etc., are sometimes valuable, as 
is the internal administration of musk, phosphorus, 
iron, quinine, etc., in proper doses, which may be 
determined from any work on Materia Medica. 

Ovarian diseases prevent conception by pre- 
venting the development of the germ cells entirely, 
or by causing them to be so imperfectly developed 
that they cannot perform their part. The consid- 
eration of diseases of this kind is not within the 
scope of this work, while displacement of the ova- 
ries, their imperfect development, together with 
stricture of the fallopian tubes, are of such a nature 
that a consideration of them would be of no value 
to the sterile woman, for nothing she can do will 
be likely to afford her relief, and we must refer 






242 PLAIN ESS CHILDBIRTH. 

them to those who make such ailments a specialty. 

The period of the greatest fecundity occurs 
on an average between the ages of twenty and 
twenty-four, and the farther the latter period has 
passed without the woman becoming a mother, the 
greater are the chances that she never will be thus 
favored. This is more particularly the case where 
no organic disease of the womb or ovaries exists as 
the prime cause. There are very many notable ex- 
ceptions to this rule, and if some other cause may 
not be determined, we would not advise the woman 
to be discouraged, for possibly nature may bring 
about some mysterious (?) change that will result 
in her maternity, Anne of Austria, and Queen of 
France — history informs us — gave birth to Louis 
XIV. after a sterility of twenty-two years ; and after 
ten years of barrenness the wife of Henry II. bore 
ten children. Horseback exercise has sometimes 
been beneficial in these cases, particularly w T hen 
carried to excess. Just before, or a few days after 
the menstrual period, conception is most apt to 
occur, particularly if total abstinence is practiced 
in the interval. 

Nursing is a fruitful cause of unfruitfulness, though 
not absolutely certain, for instances are constantly 
coming under observation in which conception oc- 
curs during nursing. It is supposed the reason is 
because the vitality of the woman is expended in 
supporting the child at the breast, by the secretion 
of the milk, during which time the ovarian and 



STERILITY. 243 

uterine function is suspended. After weaning, con- 
ception is very likely to occur, particularly if the 
mother has not seriously deteriorated in health. 

Very often the woman is blamed for unfruit- 
fulness, when she is entirely innocent, and the hus- 
band is the real culprit. Knowing, as I do, the 
extensive prevalence of self-abuse and its ruinous 
consequences on not only the reproductive organs 
but the general system, I can easily understand 
how the spermatozoa may be so defective that they 
cannot impregnate the germ cells of the woman, 
no matter how perfectly developed and matured 
these may be. The seminal fluid of the male does 
not always contain perfect spermatozoa, and if no 
good cause can be assigned for the sterility on the 
part of the wife, it is well to inquire into the condi- 
tion of the husband before the wife is subjected to 
censure. 

The husband may have had some disease at some 
time of his life that has impaired the functions of 
the testicles, or he may have done so by leading" a 
lecherous life, and I am satisfied, after years of expe- 
rience in the treatment of these affections, that 
many a w 7 ife has been unjustly blamed in the 
matter. 

Temperamental incompatibility is a cause 
often mentioned, and while it is possible it is too 
little understood to be very often considered in the 
question of reproduction, farther than to the inher- 
itance of peculiar constitutions ; electro-positive 



544 PAINLESS CHILDBIRTH. 

and electro-negative conditions are essential to the 
harmony and procrealive success of a matrimony. 
It may appear a little far-fetched, when we consider 
that the polarity of organs or bodies may be more 
or less modified or changed by circumstances, ex- 
citement, etc., yet an inquiry into the causes of 
sterility could not very well evade its considera- 
tion, and if both parents are similar in temperamen- 
tal and magnetic qualities they may be unfruitful, 
while the same parties united to others would be 
fertile. 

No better illustration of this subject is needed 
than the well-known one of the first Napoleon and 
Josephine. She had had children in her first mar- 
riage; he became a father in his second. True, 
there may arise a question of Josephine's fertility 
with another husband at the time — a question 
that will no doubt always remain open. It is, never- 
theless, a recognizable fact that certain parties are 
illy adapted to each other, socially at least, and 
though the question of temperaments has fur- 
nished a fine field for quackery, but little as yet is 
definitely known of it as a cause of sterility. There 
are many questions that rise before me as I write, 
but their consideration might lead in some cases to 
domestic infelicity, without doing much to unravel 
the mystery, and it is best that its consideration be 
made the subject of a private consultation in which 
all the peculiarities of the individual concerned 



STERILITY. 245 

may be considered ; or submitted to those who de- 
light in such metaphysical (?) inquiries. 

The question of temperaments, however, is 
one that should receive attention from marriageable 
people, even aside from its influence on fertility and 
the fruitfulness of the union. It is easy enough to 
follow the subject in the divisions laid down by 
those who have make the study a specialty, and to 
say who are best adapted to each other, but to 
carry the question to a consideration of sterility is 
extremely difficult, because there may be circum- 
stances connected with the sexual life of a husband 
and wife, before or after marriage, that no inquiry 
except made in individual consultation would re- 
veal, and I must confess that the subject in the 
present state of society seems a very unproductive 
one. 

We have already considered the most frequent 
causes of barrennes and pointed out the indications 
for their removal, many of which we are sorry to 
acknowledge cannot be carried out wholly by the 
woman herself 

In the treatment it may sometimes be found 
that after the removal of some cause the sterility 
will continue. When this is the case some other 
cause must be sought, for it so happens that occa- 
sionally a combination of causes may exist. The 
researches of Dr. Sims have shown that for the 
most part the causes of sterility are mechanical, 
and that the removal of the mechanical cause is 



24G PAINLESS CHILDBIRTH. 

followed by pregnancy in a large proportion of cases. 
J I has been my endeavor to show the barren woman 
the operation of those causes, and to point out 
others which may offer an opposition to her happi- 
ness. There are, however, still others w r hich do not 
admit of any general classification, but they are not 
very frequent, and it is presumed they operate re- 
motely rather than by being causes within them- 
selves. Of these we may mention season, climate, 
social position, sexual relations, etc. 

It is claimed that spring is the most favor- 
able season for fecundity. Climate, no doubt, 
has much to do with fecundity and barrenness, but 
it is no doubt due to the influence it exerts upon 
the general health, though it is said that the south- 
ern climate is more favorable than the northern. 
Perhaps this may be accounted for by the differ- 
ence of the sexual dispositions of those who live in 
the different climates. Sterile women, traveling 
with their husbands, sometimes find that an ocean 
voyage, or a trip to some other climate, so modifies 
and improves their general health that it ultimates 
in their becoming mothers. Social position, no 
doubt, has something to do with fecundity, and 
without making any inquiry into the sexual rela- 
tions of the rich and poor, I will state that women 
who live in luxury and fashion are not so prolific 
ns their poorer sisters. Those who are in the best 
circumstances to care for large families, rarely have 
as many children as those who find it difficult to 



STERILITY. 247 

provide for them.. It is said that in Belgium, the 
higher the price of bread the greater the number 
of children, and the greater the infant mortality. 
In another chapter allusion has been made to the 
greater prevalence of uterine disease among 
wealthy ladies in proportion to their numbers, 
which may partially account for the difference in 
the size of families. On the other hand, many 
weak and feeble women have a numerous progeny. 

Sexual relations, no doubt, exert a greater 
influence upon fecundity, fertility and sterility, than 
is generally supposed, and this is not only in rela- 
tion to the relative conditions of health, but also to 
the other relations married people sustain to each 
other. The subject, however, is one which, while 
the reader might be specially desirous of under- 
standing, my regard for propriety forbids its con- 
sideration in this place. Should those thus affected 
choose to consult me personally or by letter, I will 
endeavor to enlighten them as far as possible. 

There is an inadaptability often existing be- 
tween the parties to a marriage contract, that ren- 
ders their lives unhappy, and prevents them from 
having children. These troubles require skillful 
treatment, and are generally of such a character 
that they yield readily when the requisite skill 
is obtained, and no one should be discouraged if 
they should be unfortunate enough to at first fall 
into the hands of quacks, for those unprincipled 
rascals are plenty and are read} 7 to palm themselves 



248 PAINLESS CHILDBIRTH 

oP for scientific physicians. The sterile will do 
well to consider the subject and ask themselves the 
question, what is wrong ? When people live un- 
happy lives, who is to blame? Are both, or is 
only one ? 

Such queries may lead them to be more forgiving 
to each other and thus relieve the mental causes of 
sterility. This may seem far-fetched, and will, per- 
haps, be criticised by those who can only see causes 
of sterility in the tangible conditions already con- 
sidered, yet if the mind can influence antenatal 
conditions so as to cause "birth marks/' may not 
lack of mental, moral, social, sexual and domestic 
harmony be equally as unfavorable to the occur- 
rence of conception, as to the perfect development 
of the child that has been conceived ? 

In closing, the author hopes that a consideration 
of this chapter will be the means of directing un- 
happy and sterile wives to the realization of their 
maternal desires, as well as by previous chapters, to 
relieve the fertile ones of the difficulties aud dan- 
gers, the pains and the perils of childbirth. 



DISEASES OF WOMEN. 249 



CHAPTER XII. 



DISEASES OF WOMEN. 

Social Customs Cause Disease — Menstruation — Its Disorders — 
Ammenorrhcea — Suppression — Retention — Causes — Symp- 
toms — Treatment — Prescriptions— Anemia — Plethora — Ir- 
regular Menstiuition — Painful Menstruation — Characters — 
Treatment — Prescriptions — Profuse Menstruation — Causes 
— Treatment — Vicarious Menstruation — Leucorrhoea — 
Causes — Symptoms — Treatment — Chronic Inflammation of 
the Womb — Causes — Symptoms — Ti eatment — Constitu- 
tional — Local — Persistence Needed— Prescriptions — Ulcera- 
tion — Symptoms — Treatment — Caustics— Healing Applica- 
tions — Displacements — Different Forms of — Different 
Symptoms — Causes — Treatment — General — Local — How to 
Remove— How to Cure— -Acute vs. Chronic Displacement — 
Sub-Involution — Character — Causes — Dangers — Treatment- 
Uterine Tumors — Different Varieties — Diagnosis — Removal 
— Cancer of Womb — Change of Life — Symptoms Neglected 
— Effect it Produces on Future Health — Management — Rem- 
edies — Conditions Considered — Uterine Stricture — Cure — 
Vaginismus— How it Affects Domestic Relations — Causes- 
Treatment-- -The Ovaries— Their Importance— Their Dis- 
eases — Causes— Tr eatment-— Ovarian Tumors— The Breasts 
— Their Double Function — Diseases - Inflammation— Ab- 
scess— -Treatment-— Wasting — Causes — N on-Development-— 
Excessive Growth — Tumors— Cancers— Diagnosis — What *o 
Do 

The distinguishing characteristics of wo- 
man's organization render her liable to certain 
diseases from which men are exempt As these ail- 
ments are not necessarily associated with gestation, 
both married and single are subject to them 

A consideration of these matters does not form a 



250 PAINLESS CHILDBIRTH. 

necessary part of this book, but I have been so re- 
peatedly solicited for a book on diseases of females 
that I have concluded to add this chapter. 

Social customs impose on woman unhygienic 
conditions that impair her constitutional vigor and 
favor the development of uterine diseases. Many 
of them are primarily local, but they exert such a 
profound influence on remote parts, through the 
medium of the sympathetic nervous system, that 
the whole constitution suffers ; the functions of 
various organs are preverted and the social facul- 
ties are deranged to such an extent that the woman 
who was formerly happy and cheerful, now becomes 
one of the most miserable of beings. In this way 
derangements of the stomach, liver and kidneys 
are caused ; affections of the brain and nervous 
system are produced, dyspepsia supervenes with 
innumerable symptoms, the blood-making process 
is impaired, and often fatal consumption results. 

All healthy females are subject to a peculiar 
function that recurs periodically about once in 
twenty-eight days, between the ages of thirteen and 
forty-five. It is called the catamenia, or menses from 
mense, a month, and is characterized by the elimi- 
nation and discharge of a sanguineous fluid. This 
period of menstrual activity is subject to variation 
in different climates, and even in our own, 43 de- 
grees north latitude, remarkable instances are 
recorded where it has appeared much earlier, or 
continued much later, It defines the prolific 



DISEASES OF WOMEN. 2oi 

period of woman's life, and upon the regular occur 
rence of the function and its proper performance, 
her physical welfare materially depends. The de- 
rangements of menstruation are divided into three 
classes, viz.: Ammenorrhosa, Dysmenorrhea, Menor- 
rhagia. 

AMMENORRHCEA. 

Ammenorrhoea signifies the absence of menstru- 
ation from other causes than gestation, or the 
natural cessation at the end of the prolific period. 
When menstruation fails to appear at the proper 
age it is called retention ; when it does not appear at 
the proper time, after having been once established, 
it is called suppression. 

Retention is usually due to a delicacy of the 
constitution, in which the proper amount of vital 
stamina or nervous energy is absent, diseases of the 
lungs, liver, kidneys, scrofula, anemia, etc.; or it 
may be due to disease or absence of the ovaries, 
uterus, or vagina. The secretion may be prevented 
from escaping by an imperforate hymen. A cer- 
tain amount of physical force is necessary for the 
performance of any function, and if at the time 
the girl should develop into womanhood, anything 
occurs to lower her vitality, it will tend to prevent 
the development of menstruation. Every mother 
should be solicitous for the welfare of her daughter 
at this critical period, for carelessness then may 
cost her life. She should be instructed what she 



252 painless childbirth 

may expert at such a time, lest suddenly surprised 
she may do something to her disadvantage 

The symptoms necessarily depend more or less 
on the cause of the retention. If the ovaries or 
uterus are absent, no menstruation will ever occur, 
no matter what treatment may be tried. If there 
is imperforate hymen, or occlusion of the mouth of 
the uterus, there will be the usual monthly disturb- 
ance but the secretion cannot escape. In such cases 
there will be local pains, and as it goes on a full- 
ness, distention, a sensation of bursting, straining 
at stool and when urinating, enlargement, etc , etc 
The obstruction being of a mechanical character, 
surgical measures to establish the passage will be 
needed and must not be delayed too long, 

When due to constitutional causes there will be a 
pale, sallow, waxy, sodden, sickly appearance of the 
the complexion ; the tongue furred, breath offen- 
sive, appetite variable, morbid cravings, nausea, 
general debility, easily fatigued, languor, pain in 
the back and limbs, or bowels, cold feet, wasting of 
flesh, dyspeptic symptoms, constipation, palpitation, 
despondency, vertigo, 'headache, noises in the ears, 
and perhaps leucorrhoea, nose-bleed, etc., etc. 

Debility is the type of this condition and reme- 
dies to invigorate — to build up — must be em- 
ployed. At the same time we must attend to the 
correction of any functional disturbance that may 
occur. The blood is impoverished, there is anemia, 
and iron is generally needed j $nd as digestion is 



DISEASES OF WOMEN. 253 

usually weak and the appetite poor it can be com- 
bined with a bitter tonic with advantage. A good 
and pleasant formula is : Elixir calisaya iron and 
strychina, a teaspoonful before each meal ; or, com- 
pound elixir of phosphates is a good form in the 
same doses. They may be changed, giving one for 
a week and then the other. In some cases the ad- 
dition of a little arsenic, in the form of Fowler's 
solution, materially increases the beneficial influ- 
ence of the medicine. My prescription then would 
be: 

Compound Elixir of Phosphates, - 8 ounces. 
Fowler's Solution, - - - 1 dram. 
Dose — A teaspoonful before each meal. 

Aloes have many years enjoyed $n excellent rep- 
utation in such cases ; they improve nutrition, over- 
come the constipation and favor the development 
of menstruation. Their disagreeable taste is the 
greatest objection. The following formula is a good 
one, not unpleasant, and can usually be procured 
anywhere : 

Sulphate of Cinchona, - - - % dram. 
Red Carbonate of Iron, - - - 1 dram. 
Aqueous Extract of Aloes, - 5 grains. 

Sugar in powder, - 1 dram. 

Mix thoroughly and make thirty powders, and take one three 
times a day. 

If palpitation is annoying, in addition give three 
to five drops of the homeopathic tincture of cactus 
grandiflorus in water, three or four times a day. 

When the nutrition and blood-making process 



254 PAINLESS CHILDBIRTH. 

has been improved by the foregoing agents, we may- 
begin the use of remedies that have a direct influ- 
ence on the uterine functions, as the senecio gracilis 
— also called female regulator, life root, squaw root, 
unkum, etc. It may be given in an infusion, or 
fluid extract, or homeopathic tincture, ten to twenty 
drops three times a day in water or syrup. 

Forcing medicines are not advisable. All through 
the treatment give a nutritious diet that is easy of 
digestion, out-door exercise, pleasant scenery, rid- 
ing, etc.; abstain from labor, study or anything 
that exhausts. 

Suppression may arise from various causes, the 
most frequent of which are pregnancy or sudden 
cold. It may also be due to debility, to plethora, 
fevers or various diseases. When due to pregnancy 
it is not to be regarded as a disease. Suppression 
may occur in the most robust constitutions as well 
as in the weakly, while retention is almost always 
a consequence of debility. When suppression is 
developed gradually, the derangement increasing 
from month to month, it is generally due to some 
other disease, as scrofula, consumption, etc., and the 
treatment must be selected with a view to overcome 
those conditions, as well as to regulate menstrua- 
tion. 

Abrupt exposure to cold, getting wet at the pe- 
riod, violent mental emotions, cause sudden sup- 
pression. The flow may be suddenly arrested, or 
these causes occurring at the end of the period the 



DISEASES OF WOMEN 255 

next return of the same may not take place at the 
proper time Such cases require prompt and effic 
lent measures. When sudden cold is the cause, the 
uterus and ovaries are in a state of congestion, and 
we should employ remedies to relieve the circula- 
tion. A hot hip bath, alcoholic vapor bath, and 
hot foot bath are always beneficial ; then internally 
give: 

Tincture of Aconite, - - 15 drops. 

Tincture of Belladonna, * - 5 drops. 

Tincture of Pulsatilla, . - - 60 drops. 

Water, 4 ounces. 

Dose — Give a teaspoonful every hour., and alternate with a 
tea of serperitana, also known as Virginia snake root. 

Usually, in a few hours there will be sweating, 
relief from the fever and pain, and the flow will be 
re-established. 

If due to plethora, the use of medicines to act on 
the. bowels, and repeated frequently, are almost al- 
ways advisable. At the same time give : 

Bromide of Potass, ... 1 ounce. 

Fluid Extract Black Cohosh, « - % ounce. 

Fluid Extract Ergot, - % ounce. 

Syrup and Water, each, - - 3 ounces. 

Making in all eight ounces, and take a teaspoonful three or 

four times a day throughout the interval, and as the time for the 

flow approaches give aconite in one half drop doses every two 

hours, for two or three days, till the flow i:, established. 

Iii Lymphatic constitutions, give: 

Iodide Potash, - - 1 ounce. 

Fluid Extract Black Cohosh, » ■ % ounce. 
Fluid Extract Senecio, - - - i ouoce, 
Simple Elixir, * « =. - - .6 ounces. 
Mix Take a teaspoonful three or four times a day. 



256 PAINLESS GHILDBIBTH. 

Id anemia give the remedies advised for reteii* 
tion. iron, good diet etc In such cases a woman 
does not menstruate because she has not the blood 
to spare 

Menstruation is frequently irregular both 
as to the time of occurrence and the quantity and 
quality of the discharge. It may be too frequent, 
or too long delayed. It may be too much, or too 
little, and sometimes there will be at the period a 
colorless fluid, instead of the natural discharge 
These deviations from a natural standard are symp- 
tomatic, and are to be treated accordingly. When 
too frequent, the ovaries and uterus suffer from an 
irritable or excitable condition, and are apt to be 
congested by slight causes, and I would advise : 

Tincture of Belladonna, - - - 15 drops. 
Tincture of Apis, - - - - 10 drops. 
Water, 4 ounces. 

Take a teaspoonf ul four times a day. 

Avoid too long-continued exertion on the feet, 
excitement, etc., and use the cool hip bath daily, 
If the ovaries are sore and painful on making pres- 
sure just inside the point of the hips, alternate the 
above prescription with : 

Bromide Potash, .... 1 ounce. 
Tincture Blue Cohosh, - - % ounce. 
Tincture Nux Vomica, ... 1 dram. 
Simple Elixir to make 8 ounces. 
Dose — A teaspoonf ul three or four times a day. 

When the menses are delayed and scanty, show- 



DISEASES OF WOMEN, 257 

ing ovarian and uterine torpor, remedies to stimu- 
late this function are necessary, and if there is 
debility or anemia, combine them with iron : 

Fluid Extract Helonias, - - - 1 ounce. 

Fluid Extract Senecio, - - - 1 ounce. 

Fluid Extract Aloes, ... 1 dram. 

Simple Elixir, - - - 6 ounces. 
Dose — A teaspoonful three times a day. 

If anemia exists, give : 

Citrate of Iron and Quinine, - - 1 dram. 

Simple Elixir, 4 ounces. 

Dose — A teaspoonful after meals. 

When the period should occur a tea of mother- 
wort and squaw vine may be drank freely for sev- 
eral days. The motherwort is also known as 
leonurus cardica. 

DYSMENORRHEA. 

Dysmenorrhea signifies difficult or painful men- 
struation. A very great proportion of the women 
of the present experience pain at this time, varying 
in intensity from a slight uneasiness to the most 
excruciating agony. The character and even the 
location of the pain varies greatly in different per- 
sons, and is materially influenced by the cause. 
There are four varieties of the disease, known as 
neuralgic, inflammatory, membraneous, and mechani- 
cal, and cases are often met in which the three vari- 
eties seem to be blended in one. 

The neuralgic variety is most likely to be met 



258 PAINLESS CHILDBIRTH. 

in women of nervous temperament, in delicate 
health, and may occur at almost any period of men- 
strual life. The pain is often referred to the ovary, 
perhaps extends to the back and thighs, and is often 
intense. Cold, mental emotions, sexual abuses, 
shocks, and anything that excites or exhausts the 
nervous system may induce the attack. The treat- 
ment consists in relieving the pain at the attack 
and improving the general condition during the 
interval. The relief of the pain usually requires 
something of a narcotic or anodyne character, and 
as much as I object to the indiscriminate employ- 
ment of such drugs, the relief they afford must, 
when necessary, be the excuse for their administra- 
tion, 

Tincture of Belladonna, - - 15 drops. 
Tincture of Pulsatilla, - - - 30 drops, 
Water, ------ 2 ounces. 

Give a teaspoonful every hour until relief is obtained or the 
belladonna manifests its characteristic effect by dryness of the 
throat or dilatation of the pupil of the eye, when it should be 
suspended or given at longer intervals. 

The hypodermic injection of one-sixth or one- 
quarter grain of morphia is almost always reliable 
when all else fails. A suppository may be intro- 
duced into the rectum or vagina, containing : 

Opium, 1 grain. 

Extract of Belladonna, - - - % grain. 
Cocoa Butter, - - - - 10 grains. 

This will generally give speedy and lasting relief. 



DISEASES OF WOMEK. 259 

During the interval an effort must be made to im- 
prove the constitution so that another attack may 
not occur. Avoid tea and coffee and all stimulat- 
ing diet, excitement, sexual relations, etc. Take 
salt water baths with friction, plenty of out-door 
exercise, etc., etc., and give : 

Compound Syrup of the Hypophosphite, 7 ounces. 
Tincture of Cirnicifuga, ... 5 drams. 
Tincture of Nux Vomica, - - - 1 dram. 
Dose — A teaspoonful three or four times a day 

During the week immediately preceeding men- 
struation give the above prescription of belladonna 
and pulsatilla, in teaspoonful doses, three times a 
day. 

In the inflammatory variety there will be 
more or less of the general symptoms considered 
under chronic inflammation of the womb. The 
pain generally becomes worse when the flow is be- 
ing established, gradually increasing till it reaches 
its height, and as the flow depletes the vessels of 
the uterus it subsides. There is generally more or 
less constitutional disturbance, dragging pain in 
the hips and back that is not entirely relieved be- 
tween the periods, headache, leucorrhora, etc. This 
form is often associated with a rheumatic condi- 
tion. 

The treatment of this form of the disease will 
be more fully explained when the consideration of 
chronic inflammation of the womb is reached. 
Among the other means employed will be the hot 



06Q PAINLESS CHILDBIRTH, 

sitz bath, hot foot bath, hot vaginal injections, the 
use of opium and beiiadonna suppository at the pe- 
riod and just previous to the menstrual return, the 
glycerine and cotton tampon, medicated or not, as 
may be desired. In using the injection use a con- 
tinuous syringe, which every lady should have, and 
continue the flow as hot as it can be borne for half 
an hour or longer. It usually gives great relief 
In the use of the tampon it should be begun three 
or four days before the anticipated trouble and con- 
tinued until the flow begins. (For a further de- 
scription, see chronic inflammation of the womb.) 
For a week before the period commences take the 
following : 



Tincture of Ciinicifuga, 


2 drams. 


Tincture of Aconite, 


- 15 drops. 


Tincture of Belladonna, 


10 drops. 


Water, 


- 4 ounces 



Dose — A teaspoonf ul four or five times a day. 

The cure must be effected in the interval, as the 
measures adopted at the period can only palliate at 
best. 

Membraneous Dysmenorrhea is attended 
with great suffering, and with various modifications 
constitutes a large proportion of all the cases of 
painful menstruation. It is characterized by the 
formation of clots of dark blood, shreds of mem- 
brane, and in some cases of complete casts of the 
lining of the womb. 



DISEASES OF WOMEN. 261 

The suffering in such cases usually comes on 
from one to five days before the flow begins, with 
feverishness and constitutional disturbance, head- 
ache, backache, pain in the pelvis, and, as it pro- 
gresses, becomes periodic and labor-like, and is in 
some cases more severe than ordinary childbirth, 
and the female not unfrequently becomes uncon- 
scious. The pain is often spasmodic, expulsive and 
tenesmic, and continues until the flow is fully 
established and the membrane or clot is expelled. 
As the pain goes on month after month, local in- 
flammation is developed and adds to the difficulty. 
The general health suffers, the ovaries become con- 
gested, enlarged, extremely sensitive, the nervous 
system becomes weakened and irritable, and the 
condition is one of abject misery. 

The successful treatment of this form requires 
an unusual amount of tact and skill, associated 
with perseverance. Affecting as it does a class of 
persons among whom there is a wide diversity of 
constitutional peculiarities, the treatment will have 
to be varied to meet the conditions presented by 
each individual case. The advice already given 
for relief at the period may be used, and will no 
doubt palliate ; but it will usually be found neces- 
sary to resort to opiates or narcotics to obtain very 
marked relief. The following prescription I have 
found suitable in nearly all cases, affording tem- 
porary relief when other measures had failed. I 



262 PAINLESS CHILDBIRTH 

give the forms of the remedies most generally 
obtained at any and all drug stores : 

Fluid Extract Blue Cohosh, - 3 drams. 
Fluid Extract Viburnum, - - 1 ounce. 
Fluid Extract Gelseminum, - - 30 drops. 
Sulphate of Morphia, - - -2 grains. 
Simple Elixir, enough to make, - - 4 ounces. 
Dose — A teaspoonful every hour till relieved. 

It should be employed before the pain becomes i 
so exceedingly severe, and will prevent untold suf- 
fering. If it is carried too far, drowsiness and 
prostration, inability to open the eyes, double vis- 
ion, etc., w T ill occur, when it should be stopped for 
some hours, till these symptoms wear off. 

The application of belladonna in the form of 
ointment, or on a bit of cotton, to the mouth of 
the uterus will favor its dilation so as to permit the 
expulsion of the membrane, after which the pain 
will subside. 

It is during the interval that the treatment must 
be directed to a cure. The following prescription 
will benefit the majority of cases. 

Fluid Extract Black Cohosh, - - 1 ounce. 
Fluid Extract Squaw Yine, - - 1 ounce. 
Fluid Extract Colchicum Seed, - - J£ ounce. 

Iodide of Potass, 1 ounce. 

Simple Syrup or Simple Elixir, - - 5 ounces. 
Dose — A teaspoonful three times a day. 

If there is debility give tonics in alternation with 
the above. Some of the prescriptions already given 
containing iron will do. 



DISEASES OF WOMBX. 283 

If there is a scrofulous condition, alternate 
the above with the compound syrup of hypophos- 
phites with quinine and nux vomica, which can be 
got at any drug store, ready prepared. 

If rheumatism is the predominating 
trouble, in addition to the prescription containing 
colchicum, it will be well to give alkalies, as the bi- 
carbonate of soda in ten or fifteen grain doses, sev- 
eral times a day, dissolved in a little water. 

Throughout the treatment of such cases, a course 
of hygiene is to be carried out looking to the im- 
provement of the general health, regular hours, 
warm clothing, baths, good nutritious diet, avoid- 
ance of excesses, etc., etc. Marriage has often been 
urged as a means of cure, but with little propriety, 
for seldom has a person been benefitted when this 
form of disease exists. 

Mechanical Dysmenorrhea is due to the 
presence of an obstacle to the exit of the flow. 
This obstruction may depend on a stricture or nar- 
rowing of the uterine canal, or a curvature of the 
same to such an acute angle as to close the passage, 
to displacement, to the presence of a tumor or pol- 
ypus within the passage, or any other cause that 
tends to close the passage. These conditions cause 
sterility as well as dysmenorrhea. 

In such cases the pain will be severe, the flow 
scanty or it may escape in gushes ; ovaries become 
tender and irritable, and the whole system often 



264 PAINLESS CHILDBIRTH. 

takes on an irritable condition that is extremely 
unpleasant and annoying. A positive diagnosis 
can only be made by a proper examination. 

Treatment consists in measures to render the 
canal pervious by the removal of whatever obstruc- 
tion may exist, the dilatation of the passage by 
tents or dilators, or incisions to straighten and 
enlarge the same. Of course such measures can 
only be resorted to by a competent physician, so 
there is no need to enlarge on the subject here. 
The use of warm baths is always useful. Bella- 
donna applied locally, and the use of the prescrip- 
tion already given, and pulsatilla are always 
temporarily useful. In using pulsatilla, give two 
to five drops every two or three hours. 

MENORRHAGIA. 

Menorrhagia signifies profuse menstruation, 

and also applies to the unnatural and unusual fre- 
quency of its return. It may occur at any period 
of life from puberty to old age. It affects all varie- 
ties of constitutions, although the sanguine are 
most liable. Excessive exertion, debility, organic 
diseases of the womb and ovaries, sub-involution, 
are fruitful causes. A defibrinated condition of the 
blood, and plethora are among the most frequent 
sources of the disease. It may also be due to such 
diseases as cause anemia, tuberculosis, Bright's dis- 
ease, affections of the spleen and liver, prolonged 
nursing, anger, grief, passion, excessive exertion at 



DISEASES OF WOMEN. 265 

the period, sexual excesses, inflammation, uterine 
relaxation, tumors and polypi. The symptoms 
vary with the nature of the disease. In mild cases 
there may be more or less debility, a sense of lan- 
guor, palpitation, dizziness on exertion, etc., with 
an increased frequency or quantity of the flow. In 
the Severer cases the hemorrhage becomes exces- 
sive, the countenance pale, blanched, great prostra- 
tion, fainting, feeble and rapid pulse, uneasiness, 
every exertion causing the blood to start freely, etc. 

The treatment must be directed to modifying 
the flow at the time and to averting its repetition. 

During the flow the recumbent position should 
be enforced, and a bandage applied around the pel- 
vis and abdomen. Then give a tea made of equal 
parts of cinnamon bark, hemlock bark and witch 
hazel leaves, steeped strong. Give a tablespoon ful 
every half hour or hour, lengthening the intervals 
as the urgency of the symptoms subside. Five to 
ten grains of gallic acid in a tablespoonful of water, 
either alone or in alternation with the tea. Ten 
drops of the oil of erigeron (fleabane) on sugar may 
be used with the same frequency of repetition. 
Either of these three remedies are reliable, and 
may be used singly or in alternation. Hamam- 
melis, cannabis indica, aconite, etc., of the homeop- 
athic school, are excellent remedies. Large does of 
ergot are good, in cases where the uterus is large 
and flabby. Give a teaspoonful at once. If the 



266 PAINLESS CHILDBIRTH. 

blood is thin and defibrinated, the patient naturally 
pale, this old formula is a good one : 

Sulphate of Quinine, - - - 30 grains. 
Aromatic Sulphuric Acid, - 1 ounce. 

Mix. Dose — Thirty drops in water every three or four hours. 

If the case is urgent, plug the vagina with cloths 
or cotton wet in vinegar. 

During the interval, measures adapted to the 
peculiarities of the case should be instituted. If 
there be anemia or a lack of fibrin in the blood, 
iron is necessary. If Bright's disease, or affections 
of the spleen exist, treatment appropriate to them 
is necessary. 

If there is syphilis, an alterative and tonic 
course is needed. If it is due to sexual excesses or 
abuses, it must be abandoned and remedies adapted 
to overcome the nervous prostration associated with 
this condition are to be used. Such conditions 
should receive the attention of a competent physi- 
cian, as they are so variable that prescriptions given 
here may need to be varied more or less. A large 
proportion of cases need a uterine combined with a 
constitutional tonic, and for such the following will 
be found excellent : 

Fluid Extract Helonias, - - J^ ounce. 
Fluid Extract Senecio, - - - 1 ounce. 
Fluid Extract Trillium, - - - 1 ounce. 
Fluid Extract Nux Vomica, - - 1 dram. 

Simple Elixir, 5 ounces. 

Dose — A teaspoonful three times a day. 



DISEASES OF WOMEN. 2G7 

Give a nutritious but not stimulating diet, cold 
hip baths, sponge baths, moderate out-door exercise. 
Avoid all excitement. 

If the patient be plethoric, she should be 
given free cathartics frequently. If tumors or pol- 
ypi exist, the proper surgical treatment for their 
removal is necessary. 

If at the time when the menstrual period arrives, 
a sanguineous discharge from some other part takes 
place, it is called vicarious menstruation. It 
may occur from any part, but usually comes from a 
mucus membrane, and presents all the characteris- 
tics of the menstrual flow. When the uterine 
function is re-established, this vicarious function 
ceases. The treatment generally required is to re- 
establish the natural function, and for this purpose 
emmenagogue remedies are needed, among which 
cotton root in one or two teaspoonful doses of the 
fluid extract three times a day, for several days at 
the approach of the period, is a good remedy. Also 
senecio gracilis and other remedies advised under 
ammenorrhoea. If the discharge takes place from 
the lungs or stomach, remedies to control the hem- 
orrhage as well as to bring on menstruation may be 
required. Of course any other perverted function 
should be corrected. 

LEUCORRHCEA. 

Leucorrhoea, (fluor albus, or "whites " as it ii 
more generally called ) is one of the most common 



268 PAINLESS CRILDBIBT3. 

of female complaints. It is characterized by a dis- 
charge from the female genitals, varying in color 
from whiteish or colorless, to a 'yellowish or light 
green, to a redish or brownish, or even bloody ; in 
consistence, from thin and watery, to a thick, tena- 
cious, ropy substance ; in quantity, from a slight 
increase of the natural secretion to several ounces 
in twenty-four hours. 

It is so general that there are few females who 
are not affected by it at some period of life. It is 
even met with in infancy. It may be so bland as 
to occasion little or no inconvenience, or it may be- 
come so acrid and corrosive that it will excoriate 
every tissue with which it comes in contact ; and 
when the virulent form occurs in the married, it 
may cause in the husband an affection known as 
balanitis, which bears such a strong resemblance to 
gonorrhoea, that unjust suspicions arise and occa- 
sion much domestic unhappiness. 

The diagnosis of a virulent leucorrhcea from 
true gonorrhoea is made with difficulty, and has 
often given rise to serious inquiry regarding the 
chastity of the female. A diagnosis, however, being 
possible by competent physicians, hasty or unjust 
conclusions should not be indulged. When this 
secretion is profuse or acrid it is very apt to cause 
sterility, and not infrequently is the cause of the 
most excruciating agony during the connubial re- 
lations. 

For the most part leucorrhoea is regarded as 



DISEASES OF WOMEN. 269 

symptomatic of some disease of the uterus or vag- 
ina, of either a functional, inflammatory or organic 
character, or it may be indicative of some disorder 
of the general health. 

Anything capable of lowering vitality pre- 
disposes to leucorrhoea. It is generally present 
as a symptom or complication of almost every form 
of uterine disorder. Influences that cause inflam- 
mation, ulceration, congestion, and displacement of 
the uterus, menstrual derangement, etc., give rise to 
and perpetuate this disorder. Among the most 
common causes we may mention are luxurious liv- 
ing, sedentary habits, excessive sexual indulgence, 
masturbation, abortions, uncleanliness, piles, abnor- 
mal growths, prolonged nursing, pregnancy, too 
rapid child bearing, injuries, gonorrhoea, cold at the 
menstrual period, etc. 

Among the early symptoms are generally a 
sense of heat and soreness, amounting to pain or 
smarting, and a sense of swelling followed by the 
development of the discharge which may be a 
white, greenish, yellow, brown or reddish hue. The 
sufferer becomes pale and emaciated, her eyes look 
dull and heavy, there is severe and prolonged pain 
in the back and loins ; the functions of the skin, 
stomach and bowels become deranged, the circula- 
tion is impaired the head hot and feet cold ; there 
is a loss of strength and energy, languor, pain in 
the stomach, failure of appetite, headache, dyspep- 
sia, nervousness and hysteria. 



270 PAINLESS CHILDBiBTH. 

As the disease progresses the blood becomes 
impoverished and the female weak and emaciated ; 
the feet and ankles swell, urination becomes fre- 
quent and painful, the mind is dejected, the victim 
becomes apprehensive, despondent and melancholy. 
This state of things produces displacements, sterility 
and impotency result, and the sufferer is reduced 
to abject misery. 

The disease may be uterine or vaginal, or it 
may be a combination of both, and the character 
of the discharge as well as the symptoms will de- 
pend materially upon the cause, the location of the 
disease, and the amount of inflammation. 

The successful treatment of this affection will 
depend largely upon the recognition and removal 
of the disturbance that occasions it, the inculcation 
of proper hygienic regulations, and the employ- 
ment of appropriate remedial agencies. It will 
therefore be seen that the treatment must neces- 
sarily vary to suit the indivual case. We must 
have an avoidance of sexual excesses, while the 
mind must be withdrawn from all lascivious objects. 
Over exertion, fatigue, heated rooms must be pro- 
hibited. The most perfect cleanliness of the parts 
must be enforced, or our efforts will fail. Daily and 
thorough syringing is essential to success. The 
morbid secretion is more or less irritating of itself, 
and if allowed to remain, undergoes decomposition, 
becomes acrid and offensive, and is extremely prej- 



DISEASES OF WOMEN. 271 

udicial to the integrity of the mucous membrane 
lining these parts. 

We must seek by every means at our command 
to invigorate and improve the condition of the gen- 
eral health. Plenty of exercise in the open air, 
good nutritious diet, and regular habits are neces- 
sary, and when other diseases co-exist they must 
receive appropriate attention. 

The employment of injections of tepid water, 
soap suds, medicated or otherwise, for cleanliness 
alone, are necessary, and should be repeated at least 
once a day with a perpetual syringe that will throw 
a continuous stream, and thoroughly irrigate the 
parts and effectually wash away every particle of 
secretion. 

As an injection, water medicated with carbonic 
acid, ten to fifteen drops to a pint, once a day, is 
excellent When the smell of carbolic acid is ob- 
jectionable, permanganate of potash may be substi- 
tuted, half a dram to a quart, used freely. 

When the disease is confined to the vagina, 
astringent anti-septic lotions are desirable, of which 
the following will usually meet the indications : 

Sulphate of Zinc, - - - - 1 ounce. 
Powdered Golden Seal, - - - 3 ounces. 
Mix. Put a heaping teaspoonful in a pint of hot water, and 
let it stand till cold, and use at once, repeating it at least every 
day. 

If there is much soreness and smarting, use thQ 



272 PAINLESS CHILDBIRTH. 

following till relieved, and then use the foregoing : 

Laudanum, ----- 2 drams. 
Solution Sub-acetate of Lead, - 1 dram. 
Water (tepid), - ... 1 pint. 

Use at once. 

Constitutional treatment is essential. Tonics and 
alteratives are needed. At the same time, if any 
function is perverted it must be corrected by proper 
means. Give : 

Fluid Extract Stillingia, - - 1 ounce. 
Fluid Extract Life Root, - 1 ounce. 

Fluid Extract Black Cohosh, - - % ounce. 
Fluid Extract Buchu, - 1 ounce. 

Simple Elixir, to make 8 ounces. 
Take a teaspoonful three times a clay between meals and at 
night. 

If it has been brought on by sexual abuses, and 
the mind full of lewd thoughts, the nervous system 
irritable, add an ounce of bromide of potass to the 
above. 

Alternate the above prescription with a good 
tonic before meals. Elixir of calisaya bark and 
iron already mentioned is very appropriate. 

CHRONIC INFLAMMATION OF THE WOMB. 

This is a very common «m flection, and one which, 
while it exerts a very important influence on the 
uterine system, is very imperfectly understood, and 
often passes unnoticed and neglected. 

Modern society imposes upon woman certain un- 
hygienic customs that impair the vigor of her eon- 



DISEASES OF WOMEN, 273 

stitution, and give rise to a variety of imperfect 
physical conditions that are extremely liable, sooner 
or later, to develop an inflammation of the womb. 
The disease once established, the whole economy 
suffers ; all the vital processes are so much modified 
that a spontaneous recovery is very rare. Through 
the medium of the sympathetic nervous system, 
the morbid influence is propagated to remote or- 
gans, causing complications that are often mistaken 
for the real disease, and as may be supposed when 
such is the case, the treatment is thus rendered a 
failure. Indeed, so great is the influence exerted 
by this organ on all parts of the body, that few 
patients escape these sympathetic phenomena. 

The inflammation may attack any part of the 
organ, and the symptoms will necessarily vary with 
its location and severity, and as the disease con- 
tinues unchecked or without modification by appro- 
priate remedial agencies, it results in changes in its 
structure and position that occasion a new class of 
painful and unhappy symptoms. 

The causes of this affection are numerous, and 
may operate directly to cause the trouble, or by in- 
directly influencing the functional activity of the 
pelvic organs excite the disease; anything that 
lowers the vital standard predisposes to it. Among 
the most fruitful causes I may mention excessive 
sexuality, masturbation, prevention of conception, 
improper reading, lascivious thoughts, heated rooms, 
habitual use of cushioned seats, stimulating diet, 



274 PAINLESS CHILDBIRTH, 

cold at the menstrual period, uncleanliness, consti- 
pation, sedentary habits, violent exertion, tight 
lacing, abortions, improper management at child- 
birth, piles, inflammation of the bladder, etc. 

The most prominent local symptoms experi- 
enced are pain in the back and loins, inability to 
stand or walk, pain in the side and region of the 
bladder, sense of weight and bearing down in the 
pelvis, sometimes so severe as to occasion the most 
intense agony. Leucorrhoea is at first light colored, 
but as the disease progresses to ulceration, it be- 
comes thick, yellow, green, offensive, and often 
bloody. There is pain at menstruation, derange- 
ment of the flow, cramps, sterility and abortion. 
The inflammation increases the weight of the womb 
beyond the supporting power of its attachments, 
consequently displacements occur, occasioning new 
symptoms and increasing the difficulty. The womb 
becomes very sensitive to the touch, tender and 
painful. By pressure upon the rectum it causes 
constipation, sometimes alternating with diarrhoea, 
piles, etc. As the disease goes on the nervous sys- 
tem becomes involved, abnormal sensations are 
experienced in various parts of the body. There is 
excruciating headache, backache, spinal tenderness, 
hysteria, numbness, fainting, palpitation, difficulty 
in breathing, pain under the breast and side, feet 
and hands cold, skin dry and sallow, the stomach 
and liver become deranged, the tongue coated, 
breath offensive, the sufferer becomes feeble, cough 



DISEASES OF WOMEN. 275 

develops, and there may be rapid decline. Some- 
times the breasts are affected. There will be per- 
version of the intellectual faculties, and the victim 
becomes despondent, nervous, fretful and suspi- 
cious. 

Sterility is a frequent consequence of the disease. 
The mucous membrane may undergo ulcerative 
degeneration, and displacements almost invariably 
supervene if it continues unchecked for any great 
length of time. 

Much diversity of opinion exists as to the 
procedure necessary in such cases, and it is really 
an open question whether Gynecology, as the science 
of uterine diseases is called, is r.eally a benefit or a 
damage to the sex. If the treatment was confined 
to competent practitioners, the question would not 
admit of debate, even if differences of opinion ex- 
isted ; but in the hands of the unskillful, as is too 
often the case, not only is there no benefit obtained 
from their treatment, but the disease may be aggra- 
vated, and perhaps serious complications induced, 

It has become a fashion for physicians to make 
a specialty of "diseases of women," and every pro- 
fessional tyro believes it is " his forte." He knows 
such ills are prevalent, that they admit of good 
fees for " examinations " and " treatment," and that 
woman has been schooled to the belief that it takes 
a good while to cure, hence they have unlimited 
opportunity to prey upon the unfortunate. If the 
majority of such doctors were submitted to an ex- 



276 PAINLESS CHILDBIRTH. 

animation, they could neither explain the anatomy 
of the parts, nor diagnose the ailment, much less 
cure the disease. It is for this reason gynaecology 
is in danger of losing caste, and opens the door to 
debate whether the harm done by the unscientific 
is not infinitely greater than the good the skillful 
can accomplish. 

Local applications are doubtless good in their 
place, but the indiscriminate employment of caustics 
and what not, cannot be too severely condemned. 
When other organs become diseased they are fort- 
unately out of the reach of such torture, and are 
cured by other and more agreeable means, arid 
many may wonder if the liver and kidneys can be 
cured by other means, why uterine diseases may 
not also escape the necessity of local torture. The 
reader may think this is begging the question, and 
while I admit it may be so in some cases, the par- 
allel is often but too obvious. 

The object of local applications is for the most 
part to excite healthy action by changing the con- 
ditions that exists, and at the same time modify 
pain and irritability. When caustics are used it is 
generally with a view to excite an inflammation 
that will usurp the already existing form of inflam- 
mation, and when the artificial inflammation sub- 
sides, leave the organ in a healthy condition. 

This plan of treatment has had its advocates and 
opponents, and has been materially modified, so 
that many among our best practitioners have dis- 



DISEASES OF WOMEN. 277 

carded it. It would be exposing a professional 
secret to say that the principal need of such treat- 
ment is for the physician's benefit. 

We can excite a change in the condition of 
the uterus, relieve its dilated blood vessels, and ma- 
terially lessen its weight by the application of glyc- 
erine, which may be medicated or not, as desired. 
The glycerine is to be applied on a pledget of cotton, 
and should be renewed every day or every other 
day. Take a piece of cotton wool about the size of 
an egg, saturate it with glycerine, and apply it well 
up against the neck and mouth of the womb, and 
allow it to remain. A small string may be attached 
to the tampon to facilitate its removal, and it will 
be most conveniently applied with a pair of dressing 
forceps through an ordinary tubular speculum. 
Many succeed in applying it themselves without. 
The cotton should not contain so much glycerin -3 
that it can be squeezed out in a stream. 

The result of this application will be to excite a 
profuse watery discharge that will deplete the 
uterine vessels and induce a change in the circula- 
tion, relieving the congestion with all its dragging 
and disagreeable consequences. When it is re- 
moved, thoroughly syringe the parts, removing 
every particle of morbid secretion, and repeat the 
application. 

In long standing cases when the womb has be- 
come enlarged, a little tincture of iodine may be 
added to the glycerine in the proportion of one 



278 PAINLESS CHILDBIRTH, 

dram to the ounce, and applied in the same man- 
ner. 

If there is tenderness and pain that does not 
yield to the use of glycerine alone, laudanum may 
be added, provided there is no circumstance con- 
nected with the patient that prohibits the use of an 
opiate. 

After the congestion and inflammation have 
been reduced by this treatment, it will be necessary 
to follow up the advantage gained by the use of 
astringents and tonic applications, which may be 
applied on cotton in the same manner. The fluid 
extract of golden seal or, witch hazel, or pinus can- 
adensis may be mixed with glycerine in about equal 
parts of whichever one is selected and used. As 
these applications stain the clothing, proper precau- 
tions to prevent such a consequence should be taken. 
Sitz baths may be employed with great good, but in 
their use it may be necessary to accustom the pa- 
tient to them. They may be begun warm or tepid 
and the temperature gradually lowered until in a 
few days they are employed cold. They should be 
followed by brisk rubbing to excite vigorous reac- 
tion. When, however, they are intended to relieve 
pain, soreness or excitement they should be used 
warm or even hot. 

The employment of local applications must not, 
however, be regarded as the sine qua non.. We have 
several medicines about the remedial influence of 
which, on these parts, there cannot be any doubt, and 



DISEASES OF WOtiEF. 279 

their employment must not be over looked. Their 
combination or alternation with agents that control 
special symptoms and conditions that are outgrowths 
of the main disease, must constitute an essential 
feature of the treatment. 

The black, and blue cohosh, the squaw vine, Pul- 
satilla, lady slipper, bromide of potash, etc., may be 
used singly or in combination, for their influence in 
diminishing pain, controlling inflammation and re- 
lieving reflex-excitability. They overcome the 
nervousness that almost invariably attends inflam- 
mation of the womb. 

The following prescription is a good one. Take, 
of the homeopathic tincture or fluid extract, the 
tincture being preferred, thus : 

Tincture of Pulsatilla, - - - 1 dram. 
Tincture of Black Cohosh, - - 2 drams. 
Water or Simple Elixir, - - - 4 ounces. 
Mix. Dose — A teaspoonful three or four times a day. 

After it has been taken two or three weeks, sub- 
stitute the following : 

Fluid Extract Mitchella Repens, - 1 ounce. 
Fluid Extract Caulophyllum, - 3€ ounce. 
Fluid Extract Cypripedium, - % ounce. 
Bromide Potass, - - - ~ % ounce. 
Simple Elixir, enough to make 4 ounces. 
Mix. Take a teaspoonful three or four times a day. 

The use of nux vomica given alternately with 
either the above, on the same day is advisable. To 
avoid too many medicines it may be given in com- 



2S0 PAINLESS CHILDBIRTH. 

bination with other remedies if any are being given 
at the same time. If there is much breaking down 
of the system in general, it may be combined with 
iron and quinine in form of a pill or syrup, or 
where the nervous symptoms predominate with 
phosphorus, thus : 

Tincture Nux Vomica, - - - 1 drain. 
Quinine, - - - - - 30 grains. 

Syrup Hypophosphites, . _ .4 ounces. 

Dose — A teaspoonful three times a day, just before or after 
eating. 

It is not usually advisable to continue any 
prescription too long without a change, or the 

beneficial effect will be lost. For that reason I sel- 
dom give large prescriptions except the patient 
lives at considerable distance, when I give enough 
to last a month at a time. Special symptoms must 
always be considered in making prescriptions, and 
in this disease they are so exceedingly numerous 
that not a little tact and judgment must be exer- 
cised. Constipation is a very frequent symptom 
and one that should not be over looked. Many of 
the cathartics usually employed increase the deter- 
mination of blood to the pelvis, and therefore should 
be avoided in all cases. The nux vomica in many 
cases will be all that is necessary. When it is in- 
sufficient, salines are advisable. Eochelle salts, 
seidlitz powders, citrate of magnesia or even some 
of the laxative waters. Common Epsom salts in 
small doses every morning in some cases do great 



DISEASES OF WOMEN. 281 

good. The following makes a very good aperient 
and tonic : 

Epsom Salts, 2 ounces. 

Sulphate of Iron, 3€ ounce. 

Cider, 1 pint. 

Mix. Dose — A tablespoonf ul once to three times a day. 

The cider relieves the unpleasant taste of the 
salts. The iron may be left out if the patient is full 
blooded. 

Trouble with the bladder often demands re- 
lief temporarily while the real disease is being 
treated. The smarting and burning, and frequent 
desire to urinate can usually be relieved by : 

Tincture Cantharides, - - - 10 drops. 

Water, 4 ounces. 

Dose — A teaspoonf ul every two or three hours. 

As soon as relief is obtained it should be omitted. 
The headache will generally yield when the cause 
is removed, but during a severe attack thirty grains 
of bromide of potass may be taken and repeated in 
two hours if need be. Take it dissolved in water. 

The sitz bath is an agent of great value, and 
should always be employed as an adjunct to other 
measures. The directions given for its use in this 
and in a preceding chapter are equally appropri- 
ate. A change of habit is beneficial. Indolence 
must not be tolerated and on the other hand exces- 
sive labor should be avoided. Heavy lifting is to 
be prohibited, as it would be very likely to cause 






282 PAINLESS CHILDBIRTH. 

displacement. Marital relations must be suspended 
entirely or nearly so, and care must be exercised to 
avoid any circumstance that could cause any form 
of sickness, on account of its liability to aggravate 
the disease being treated. 

Perseverance is necessary for success, and 
as improvement progresses carelessness cannot be 
indulged. I have seen the slightest indiscretion 
cause a relapse as severe as the original disease. 
Occasionally there will be cases so obstinate or com- 
plicated as to demand the greatest professional skill, 
and no general rule can be written that will suit 
all. I have endeavored in this chapter to avoid ad- 
vising such ' measures as would Jbe impracticable, 
and have necessarily confined myself to the more 
simple and easily applied forms of treatment, and 
should any one find the directions inadequate to 
meet all the contingencies that grow out of so varied 
and troublesome a disease, I will be pleased to con- 
sider the case in its individuality, and render such 
service or advice as may lead to its cure. 

I have purposely omitted a discussion of the va- 
rieties of inflammations and their divisions by 
localization, as such a consideration could only re- 
sult in confusing the unprofessional. To them the 
fine distinctions as to whether the inflammation is 
limited to the mucous membrane of the uterine 
neck or to the deeper structures, whether these con- 
ditions are confined to the neck of this organ or 
whether they extend to and involve the whole or 



DISEASES OF WOMEN. 283 

only a part of its body, is a matter of no practical 
value, as the symptoms would not enable them to 
diagnose or even treat the matter with any material 
difference; for this reason they have been omitted, 
and not because, as some critical individuals may 
claims on account of carelessness or indifference. 

ULCERATION. 

This is a frequent result of inflammation, and 
presents several varieties, varying from a slight 
abrasion to a deep seated intractable sore. It may 
be limited to a superficial ulceration, or erosion of 
the mucous membrane of the neck or mouth of the 
womb, or it may extend into the body of the organ 
and into the deeper tissues. This is one of the 
great hobbies of the so-called "specialist" and if the 
patient's financial capability admits, " ulceration " 
is found. Do not understand me as denying the 
existence of such a disease, but that it is not always 
present. It is likely to result when the inflamma- 
tion has continued for a long time unchecked, or 
been improperly treated. It indicates impairment 
of vatility, either local or general, or both. The 
degeneracy of tissue may be local, but cannot exist 
long without more or less injury to the general 
health, if, indeed, the general health has not been 
materially impaired before the ulceration occurs. 

The symptoms will necessarily differ according 
as the ulceration is superficial or deep, limited or 
extensive^ and will accord more or less with tnose 



284 PAINLESS CHILDBIRTH. 

already described under chronic inflammation. 
There will be leucorrhoea, varying from slight 
milky, watery or colorless, to thick, tenacious, puru- 
lent, green, lumpy or bloody. There will be pelvic 
and sacral pains, backaches, ovarian irritation, dys- 
pepsia, irregular menstruation, menorrhagia, neu- 
ralgia, pains in various parts, irritation of the 
bladder and rectum, debility and more or less dis- 
turbance of the general health. A positive diag- 
nosis without the speculum is impossible, the 
employment of which reveals the presence or 
absence of the ulcer and its character, A cele- 
brated writer has said : 

Treatment of uterine ulcer is one of the most important and 
difficult in the whole range of medical science. 

We must be guided by the character and extent 
of the ulcer, the existing inflammation and the 
state of the general health. The employment of 
local measures are necessary. Caustics, stimulants, 
astringents, etc., must be selected with care. In 
mild cases carbolic acid applied full strength, nitric 
acid applied on a pine stick, dipped in the acid and 
allowed to dry before applying, will generally suffice, 
but in more deeply seated sores, more vigorous 
treatment may be necessary — caustic, potash, solid 
nitrate silver, chromic acid, etc. When applying 
them the adjacent parts must be carefully protected. 
It is always best to employ a physician who under- 
stands such diseases and who is provided with 



DISEASES OF WOMEN. 285 

proper facilities, and who will necessarily conduct 
the subsequent treatment. In mild cases fluid ex- 
tract golden seal, or pinus canadensis may be ap- 
plied on lint, and changed daily with injections to 
thoroughly cleanse the parts and then repeat the 
applications. Healing injections of an infusion of 
white pond lilly root, golden seal and witch hazel, 
with chlorate of potash one-half ounce to the quart, 
are useful and may suffice in the milder cases. 

Some physicians apply an iron, devised for the 
purpose, heated to a white heat. Some apply tinct- 
ure of iodine, and follow with the glycerine and 
cotton dressing already described under inflamma- 
tion. The plans of treatment are as various as 
physicians are numerous, and as the afflicted are 
not apt to try it themselves, minute description is 
not necessary. 

Whatever local measures are adopted, the plan is 
to destroy the ulcer and make a healthy sore, or to 
so stimulate the tissues in which it is seated as to 
bring about a healthy action. 

As already remarked, we will usually find an im- 
pairment of the general health, which must be 
built up or we cannot hope to succeed. It is im- 
possible for a sore to heal while the blood is impov- 
erished and impure, the fluids of the body perverted 
and the nervous system morbidly acute. Inculcate 
thorough hygiene, open air exercise, salt water 
baths, generous but unstimulating diet, regular 



236 PATHLESS CHILDBIRTH. 

habits, avoidance of fatigue and sexual relations, 
then take the following : 

Fluid Extract Corydalis, - - 1 ounce. 
Fluid Extract Cypripedium, - - 1 ounce. 
Fluid Extract Hydrastis, - - 1 ounce- 
Fluid Nux Vomica, ... 1 dram. 

Simple Elixir, 5 ounces. 

Dose — A teaspoonf ul before meals three times a day. 

This may be advantageously alternated with ten 
to fifteen drops of dialized iron in water three times 
a day. Build up the vital forces by every possible 
means. A condition akin to scrofula obtains in 
many of these cases, that must be overcome or the 
ulcer will not heal and there will be danger of de- 
veloping consumption. At the outset, understand, 
time and perseverance are necessary. The forego- 
ing are but a few of the many remedies at our com- 
m.ind, which come under the general classifications 
of alteratives and tonics, and are useful in depraved 
conditions of the system, but as these cases seldom 
undertake to conduct their own treatment, they are 
probably sufficient to indicate the character of the 
treatment needed in a general way. 
DISPLACEMENTS. 

There are three principal varieties of uterine dis- 
plicement: Downward (prolapsus), backward (re- 
troversion), forward (ante-version) A slight deviation 
from the normal position may occur without occa- 
sioning any very serious trouble, but as the degree 
of deviation is increased, the trouble arising from 



DISEASES OF WOMEN. 287 

such displacement is augmented. Displacements to 
one side may occur but are not so frequent. Two 
other forms of displacement are met with in which 
the neck remains in its natural position, and the 
body is displaced. This of course necessitates a 
bending of the neck. When the body is tipped 
backward it is called retro-flexion, if forward ante- 
flexion. 

Displacements are usually complications, 
and effects of inflammation, although they may be 
produced by heavy lifting, or jumping, or falling 
from a height and striking on the feet. 

The nature of the displacement involves the con- 
dition of other organs, and the symptoms necessarily 
depend in a measure, on the character and degree 
of displacement. 

When the displacement is downward, 
which is the form most frequently observed, there 
is painful dragging and bearing down, sometimes 
so severe that it seems as if the whole of the con- 
tents of the pelvis would be forced outside of the 
body, backache, headache, pain in the limbs and 
perhaps swelling of the feet. The pressure on the 
rectum causes piles and constipation, difficulty in 
urinating, etc., a sinking and sense of goneness in 
the stomach and all the symptoms that accompany 
the inflammatory troubles already described. 

When it is backward, in addition to the symp- 
toms of prolapsus which generally are present, the 
pain in the back is greater and often extends to the 



288 PAINLESS CHILDBIRTH. 

head, and the pressure on the rectum may be so 
great as to render an evacuation of the bowels 
almost impossible. An examination reveals the 
mouth of the uterus pointing toward or pressing 
against some part of the bladder, and the body 
may be felt lying in the hollow of the sacrum. If 
the case is one of ante-version, the body of the 
womb presses forward and downward upon the 
bladder, while the mouth is turned backward in 
the hollow of the sacrum. The bladder becomes 
very irritable, and the suffering is often intense. 

Usually the symptoms are so plain that a diag- 
nosis can be made from the statement of the patient, 
but there is a possibility of error. Tumors consti- 
tute the principal causes of mistake. 

In the flexions, in addition to the foregoing 
symptoms, the neck of the womb being bent on it- 
self backward or forward as the case may be, is 
likely to obstruct the canal and become an impedi- 
ment to the exit of the menstrual discharge on 
hand, or the ingress of spermatozoa on the other, 
causing in Ihe first instance, dysmenorrhoea, in the 
other barrenness. 

Take the finger of a glove in your hand up to 
the middle and allow the hand to fall over and you 
have a fair idea of the operation of a uterine 
flexion. 

As I have already remarked, these displacements 
are usually directly or indirectly, caused by inflam- 
mation in some form or other. If this pathological 



DISEASES OF WOMEN. 289 

fact is borne in mind it will be of great value in 
understanding the treatment. 

As already stated, inflammation is the most 
potent cause of uterine displacement. Con- 
gestion, operating in the same way, is also a fruit- 
ful cause. They act as causes by increasing the 
weight of the uterus beyond the power of its sup- 
ports to hold it in place. Anything that increases 
its weight predisposes it to displacement; violent 
exertion or even long continuance in the erect post- 
ure under such circumstances cause it to settle into 
displacement. When congested or inflammed, 
jumping, jolting, lifting, straining, dysentery, etc., 
etc., displace it. 

The sufferings caused by it can only be appreci- 
ated by those who have experienced it. In some 
the deviation has been gradually effected and they 
do not seem to suffer acutely, others are unable to 
walk or stand. When it has occurred suddenly as 
a result of a strain, or fall, or lifting a heavy weight, 
the suffering is often described as acute. Very sel- 
dom, however, if ever, does it occur without causing 
more or less suffering and constitutional disturb- 
ance, and when it has once occurred it is very apt 
to recur. 

The inflammation extending to adjacent struct- 
ures sometimes causes adhesions that securely fasten 
the organ in its false position and entail lifelong 
trouble. This one circumstance points out the im- 
portance of early efficient treatment. 



290 PAINLESS CHILDBIRTH. 

There are few troubles that assail human beings, 
the treatment of which have received more atten- 
tion than this. Supporters without number have 
been devised. When they have been arrayed for 
examination it would almost seem as if the inge- 
nuity of man had been exhausted. Every con- 
ceivable form and shape, from a ball to a horse 
shoe ; from a simple cup to the most complicated 
receptacle^; light and heavy, large and small ; some 
easily adjusted, others that cannot be; indeed, a 
large majority of them seem to have been built 
without any regard whatever to the purpose they 
they were intended to serve. Many of them relieve 
one pain to cause another. It would take the whole 
book were I to attempt to describe them. Probably 
they will always be in demand ; almost all physi- 
cians use them. Indeed, it is fashionable I No 
physician wants to show his ignorance by admitting 
he don't understand one, or know how to apply it. 
Of course anyone can apply one, even if it is ad- 
justed wrong side up ! 

There is a principle involved in the cure of these 
troubles that it will be well to remember. The 
effect of inflammation and congestion is to increase 
the size and weight of the womb, so that it is dis- 
posed to fall from its natural position by its own 
gravity, when its supports have become weakened. 
A supporter may elevate it to its natural position, 
but it does not overcome the increased density nor 
strengthen the supports. If properly adjusted the 



DISEASES OF WOMEN. 291 

supporter may afford relief, but not cure. At best 
they are but an auxiliary, and those who rely on 
them as curatives can but meet with disappoint- 
ment. 

The indications then are to arrest the inflamma- 
tion, remove the extra weight occasioned by it and 
strengthen its supports. Were I writing this chap- 
ter especially for the profession, I should consider 
the physiological and patholQgical conditions in- 
volved more at length ; as it is, probably it is 
unnecessary. 

We will frequently find cases where the inflam- 
mation has subsided and its consequences alone re- 
main ; again the inflammation continues. In 
either case, we must adapt the treatment to the 
needs of the individual. 

Replace the womb, and if there is inflamma- 
tion proceed as advised under that head, using the 
cotton tampons properly applied, instead of a sup- 
porter. Medicate it if necessary, The cotton will 
not cause the pain a hard instrument will, while it 
can be made a medicated appliance to cure the in- 
flammation instead of increasing it, as is sometimes 
the case with solid supporters. 

By adapting the size, shape and position of the 
cotton supporters, the uterus can be maintained in 
position. 

When the inflammation does not require special 
medicines for its control, alteratives to overcome 



292 PAIFLESS CHILDBIRTH 

the adventitious deposits that increase its weight 
are to be administered. Take : 

Fluid Extract Corydalis, - - 1 ounce. 
Fluid Extract Ergot, 1 ounce. 

Fluid Extract Black Cohosh, - % ounce. 
Nitrate Potash, - % ounce. 

Simple Elixir, to make 8 ounces. 
Mix. Give a teaspoonful three times a day. 

Overcome the muscular weakness of the uterine 
supports by tonics, exercise, etc., thus : 

Fluid Extract Nux Vomica, - - % dram. 
Fluid Extract Golden Seal. - - 2 drams. 
Elixir, to make, 4 ounces. 
Dose — A teaspoonful at meals. 

The existence of other symptoms that demand 
attention may require that other agents be added 
to these prescriptions to fulfill the special indica- 
tions. 

Sitz baths cold, thorough rubbing, are advisable. 
Exercise that brings the relaxed muscles into play 
and develop their strength, should be employed ; 
carefully at first, increasing as it will answer. 

We must remember that the contents of the ab- 
domen are disposed to press the contents of the 
pelvis downward and thus interfere with the cure 
of displacement. Many females of a lax muscular 
habit are thus affected to a great extent and should 
be aided by an external band or support, as it will 
afford relief from many distressing symptoms. 
They should, however, remove this artificial sup- 



DISEASES OF WOMEN. 293 

port at stated intervals, and take such exercise as 
will bring the muscles involved into action, and 
thus develop them. Nearly any treatise on calis- 
thenics will give the information needed on these 
points. 

Any muscle that has its function suspended for 
any considerable length of time becomes weakened 
and attenuated ; hence, I say, supporters cannot 
cure their debility, and I wish to avoid them. A 
great deal of discretion, however, is needed to de- 
termine when, and to what extent supports should 
be used. No absolute rule can be laid down. We 
must be governed by the circumstances and condi- 
tions present. 

Tonic and astringent medicaments are required 
as applications with the cotton tampons, and injec- 
tions during the time to overcome the relaxation of 
the pelvic tissues, and the pinus canadensis, the 
golden seal, witch hazel, etc., may be used as already 
suggested in the treatment of chronic inflamma- 
tion, after the inflammatory symptoms have 

yielded. 

Much care will be needed to adjust the tampons 

properly to secure the greatest benefit from their 
use. They should be changed daily. 

To replace a displaced uterus is not always 
as easy as may be supposed, and many who have 
tried it and been disappointed in the success of 
their efforts will often regard themselves as unequal 
to the task. If there are no adhesions binding it 



294 PAjNLESS childbirth. 

firmly in its malposition, it can be easily accom- 
plished, 

First remove the weight of the abdominal 
viscera, take advantage of the law of gravity, se- 
cure the aid of atmospheric pressure if needed, and 
accomplish the rest by manipulation. The first 
and second steps are accomplished by position 
Let the patient kneel upon a table or some unyield- 
ing surface, lounge, sofa, or even the flour, then 
bending the body forward until the chest and abdo- 
men lie upon the table, tilt the body slightly to the 
left so the left side of the face and shoulder are 
upon the table, the arm thrown behind her, the 
hips being kept elevated as high as the length of 
the limbs from the knee to the hip will admit 

This position relaxes the abdominal muscles 
and the contents of the abdomen gravitate toward 
the chest, entirely removing their previous weight 
from the pelvis; The contents of the pelvis are 
now at liberty to gravitate toward the abdomen, 
and in some cases will do so without any help, re- 
sume their natural position. If now an effort is 
made by manipulation, to replace the uterus, tho 
air fills the vagina and by its pressure crowds the 
pelvic organs towards the abdomen. In simple 
prolapsus, or downward displacement, this will usu- 
ally be sufficient, but if there are adhosi^ns, of 
course no change will be effected. 

Sometimes when the case is one of retroversion, 



DISEASES OF WOMEN 295 

the uterus is wedged into the hollow of the sacrum 
so securely that manipulation will be necessary, and 
the operator will often be surprised to find the uterus 
suddenly leave his fingers and resume its normal 
position, even in cases where ail previous efforts 
had been unavailing. 

If an unprofessional person cannot effect a re- 
placement by this method there is little use of 
trying further. 

If now a supporter has been selected it should be 
adjusted at once, otherwise the cotton tampon 
should be inserted before the woman changes her 
position, and while the womb is in its natural posi- 
tion, or perhaps a little higher up than natural, 
after which let her lie down and rest a little while 
before she makes an attempt to get upon her feet. 

In chronic cases there will be a disposition to get 
out of place, but the woman has it in her power to 
relieve herself at any time when she finds herself 
in agony from a sudden displacement, if she will 
but make endeavor as above described. 

This plan may have to be repeated in long stand- 
ing cases many times, and at the same time there 
should be a constant endeavor to invigorate the 
whole system, to renew the supporting power of the 
attachments so that they can hold the organ in its 
proper position without the aid of any artificial de- 
vices. Instrumental supports seek to hold the 
organ in its place independent of change in the 
condition of the organ itself or improvement of its 



296 PAINLESS CHILDBIRTH. 

muscular attachments. They do not cure but sub- 
stitute. 

By the plan I have just described, to the origi- 
nality of which I make no claim, we seek to make 
a permanent cure, using mechanical aid only as an 
adjunct, and to temporarily effect what we endeavor 
by this and other means to make lasting. 

Although I have argued against artificial sup- 
porters, (instrumental) I do not wish to be under- 
stood that they are useless ; such a position would 
be extremely ridiculous in the face of their employ- 
ment by some of the brightest lights of the profes- 
sion. I am aware that there are cases in which 
there is nothing left but to use them, and it is cer- 
tainly better to do so than to have the woman 
suffer. A I, however, wish to avoid them when possi- 
ble ; I wish to cure instead of simply relieve, and 
am confident that properly managed cases can be 
cured by the foregoing plan, in which the artificial 
treatment has previously failed. 

SUB-INVOLUTION. 

Daring gestation, to accommodate the develop- 
ment of the foetus, the uterus is necessarily increased 
in size. The walls do not become thicker but more 
extensive. The return to its former size after de- 
livery is termed involution. If this process is 
arrested before it is complete the uterus is left in a 
state termed sub-involution. 

The cause of this arrest is generally inflamma- 



DISEASES OF WOMEN, 297 

tion, the degree of which is various. It may or 
may not be attended with febrile symptoms, the 
contractions are feeble and inefficient, the muscu- 
lar wall loses its power to effect the shrinkage nec- 
essary. While this condition lasts there is danger 
from hemorrhaga As time wears on and the acute 
are succeeded by chronic symptoms, the danger of 
sudden hemorrhage may subside ; but there remains 
more or less disturbance of the uterine function, 
liability to displacement, etc. 

Women are often heard to say they have never 
been right since their baby was born. In many of 
such cases the process of involution has doubtless 
been arrested before completion. The best time to 
correct this is when it occurs If the womb remains 
large, flabby, hemorrhage continues, pain, weight, 
heat in the lower abdomen and pelvis, it should 
receive attention. 

If the inflammatory symptoms run high, use 
aconite, or veratrum, or pulsatilla in small and fre- 
quently repeated doses, say fifteen drops of either, 
or each, in a glass two-thirds full of water, and take 
a teaspoonful every hour or two. Alternate this 
with : 

Fluid Extract Ergot, - - % ounce. 

Fluid Extract Black Cohosh, - 3€ ounce. 

Water, «• 2 ounces. 

Dose — A teaspoonful every four hours. 

After the case has become chronic (and they are 
met with months or years after the delivery,) a 



1 


ounce, 


k 


ounce. 


- H 


ounce. 


2 


ounces. 



293 PAINLESS CHILDBIRTH. 

course of treatment must be instituted to remove 
adventitious deposits and restore the natural func- 
tions of the womb and ovaries, together with such 
local applications as shall excite .a new and more 
vigorous activity in the absorbents of these parts. 
Take : 

Fluid Extract Corydalis, 
Fluid Extract Phytolacca, 
Fluid Extract Pipsissewa, 
Simple Syrup or Elixir, 
Dose — A teaspoonful three or four times a day. 

If there is a disposition to hemorrhage or profuse 
menstruation, substitute an equal quantity of fluid 
extract of beth root (trillium) for the phytolacca (poke 
root.) If there is anemia give tonics, some of the 
formula already given will answer. Local applica- 
tions are valuable. Iodine may be used either 
applied to the womb directly and followed by the 
glycerine and cotton tampon, or it may be applied 
mixed in the glycerine as advised in chronic in- 
flammation. Ail external supporter made to fit 
evenly and moderately 'compress the abdomen, will 
be found useful. 

Out door exercise to invigorate, bathing, etc., 
should be thoroughly carried out. 

Usually these cases require great perseverance. 

UTERINE TUMORS. 

All organized growths that occur within the 
uterine walls or are attached to any of its surfaces 



DISEASES OF WOMEN. 299 

are properly called tumors. Several varieties exist 
— polypus, fibrous, fibro-cellular, vesicular, cellular 
or mucus, vascular and encysted. They are vari- 
ously distinguished by position and relation to the 
different parts of the uterus. 

Polypi are pendulous growths attached to some 
portion of the uterine mucous membrane by a nar- 
row neck, varying m density, and causing a variety 
of smyptoms that depend to a considerable extent 
upon the seat of their attachment. When located 
within the cavity of the uterus they are apt to de- 
range menstruation, rendering it profuse, causing 
dragging, etc ; being out of reach they may not be 
detected for months and years. The neck may be- 
come elongated and the body be expelled outside 
the uterus, where it hangs till removed by surgical 
means. They may occur in the canal and obstruct 
the menstrual flow, causing great pain and making 
the flow exceedingly profuse. In such position they 
can cause absolute sterility. They may be attached 
to the mouth of the uterus within easy reach. 

Their only treatment is removal by surgical 
means. 

Fibrous tumors are by far the most frequent, 
difficult to manage and dangerous. TFhey may oc- 
cupy any part of the uterine substance, but are 
oftenest found in the posterior wall, and are gener- 
ally round or oval in shape. The size varies very 
considerably, Increasing the size and weight of 
the uterus, they cause displacement, 



300 PAINLESS CHILDBIRTH. 

The great danger is from hemorrhage, which 
does not by any means bear a definite relation to 
the size of the tumor. The menstrual function is 
deranged, sterility is likely to result, or if concep- 
tion takes place abortion will be very likely to 
follow. 

The diagnosis is not easy, Recurring hemor- 
rhage causes suspicion of their presence, particularly 
if there be existing displacement. Careful manip- 
ulation is necessary, and the use of the sound will 
be required before a diagnosis is certain. Skill is 
needed to make certain the existence of the tumor, 
its location, etc. 

There are other forms of morbid growths from 
the interior of the uterus that give rise to pressure 
and hemorrhage, the removal of which is necessary 
to a cure. 

The treatment of these affections is very difficult. 
To control hemorrhage is one of the first things to 
be considered. If we cannot cure we can prolong 
life. The removal of the tumor is the only way to 
effect a permanent cure. This is often very trouble- 
some and in some cases impossible. A knowledge 
of the character, location and attachments of the 
growth are necessary before we can form an opinion 
of the success of the treatment or the plan to be 
pursued. 

To arrest the hemorrhage boldness and energy are 
often required. Give ten grain doses of gallic acid 
in water, and repeat every half hour ; twenty drops 



DISEASES OF WOMEN. 301 

of the oil of erigeron on sugar repeated every half 
hour; a strong tea of cinnamon, hemlock and 
witch hazel barks, given quite freely and often re- 
peated ; if the structure of the womb is soft, lax 
and flabby, teaspoonful doses of the fluid extract of 
ergot repeated as often as necessary from twenty 
minutes to four hours, are among the most prompt 
and convenient remedies. Keep the patient in the 
recumbent position, in a cool room, allow nothing 
but cold drinks, lower the head and elevate the 
pelvis. 

Local measures must not be overlooked. As- 
tringent injections may be used, fill the vagina 
with cloths or cotton steeped in some astringent — 
alum or vinegar if nothing else is at hand. Be 
thorough, a life may be sacrificed by delay. Apply 
ice to the pelvis. A gum-elastic air bag, if at hand, 
may be introduced and inflated, completely plug- 
ging the passage, and preventing the escape of the 
blood. Some of these means can alwa3 7 s be em- 
ployed while waiting for remedies administered 
internally to take effect. 

Various plans have been advocated for the re- 
moval of those growths. If it is polypoid and in 
reach its removal may be effected by grasping with 
forceps and twisting its neck from its attachment 
and dressing with astringents. 

If the growth is of a mushroom character, growing 
from the mucous membrane, in which case bits like 
* proud flesh " may be expelled occasionally, the 



302 PAINLESS CHILDBIRTH. 

womb must be dilated and removal effected by in 
struments adapted to the purpose. 

Fibroid and other tumors require surgical treat- 
ment. Caustics to cause their separation by 
sloughs have been successful. Electrolysis has been 
successful in some cases. The injection of Iodine 
and other substances into the tumor with an instru- 
ment invented for this special purpose has been 
employed of late years. Various other means have 
been resorted to, but as all forms of them are at- 
tended with great difficulty and require patience 
and skill, I need not detail their modus operandi 
here, as it is not expected their removal will be at- 
tempted by other than competent physicians. 

Such various means as have already been recom- 
mended to build up and strengthen, are always in 
order, among which acids are most appropriate as 
they counteract the hemorrhagic tendency to some 
extent. 

CANCER. 

A consideration of this disease is of too much 
gravity to enter into a work intended for public 
guidance. The disease must be dealt with promptly 
and thoroughly if at all, and no one should tamper 
with it unless qualified by clinical experience, and 
armed with the necessary means, to carry out what- 
ever proceedure is determined upon. 

A consideration of the symptoms may, however, 
be appropriate, as they may induce some of tho 



DISEASES OF YfOMEN. 803 

afflicted to seek proper relief before it is too late. 

Discharges, pain and fetor, are the symptoms that 
most generally attract attention ; and when these 
three are present the case is most generally an ad- 
vanced one. The pain is characteristic, lancinat- 
ing, darting, twinging. The discharge consists oi 
blood, limpid serum, minute sloughs. The blood 
and serum do not cause the fetor ; it is the disin- 
tegration of the sloughs — cancer cells. In women 
who are still menstruating the first discharge is the 
blood, then an increase of the menstrual flow, then 
blood between times — all from the mucus mem- 
brane of the uterus, 

Later, however, when the hemorrhage is constant 
and is attended with fetor, it is effused from the 
eroded vessels upon the ulcerated surface — in the 
one case the result of turgessence, in the other dis- 
entegration of tissue. Limpid, inoffensive serum, 
is almost always observed, after the menstrual pe- 
riod, in women about the change of life, and very 
gradually this transparent liquid becomes colored 
with blood ; after a while it becomes fetid, etc. 

Lancinating pain, sero-sanguineous discharge, 
peculiar fetor, persistently continuing for days and 
weeks, are distinctive of cancer. With these we 
have the peculiar constitutional condition known 
as the cancerous diathesis. Cancerous anaemia, with 
the straw-colored translucency of the skin, known 
as the cancerous cachexia, constitutional carci- 



304 PAINLESS CHILDBIRTH. 

noma, with the impairment and failure of function 
in a long struggle with pain, loss of blood, anxiety 
and inaction, together with debility, indigestion, 
palpitation, restlessness, neuralgia, constipation in 
the early stages and colliquative diarrhoea in the 
latter, apthse, night sweats, wandering of the mind, 
together with pain and exhausting discharges, are 
the destroying agencies. 

As already stated, I will not advise as to treat- 
ment. I know of no specifics or anything approach- 
ing to them, but do what you may, I beg of you to 
steer clear of cancer quacks and incompetent phy- 
sicians. 

CHANGE OF LIFE. 

After years of menstrual activity the woman 
undergoes another change and she ceases to men- 
struate. The age at which this occurs varies greatly. 
Forty -five is considered the average, but numerous 
cases occur in which it is continued for several 
years later. The cessation of this function is 
often attended with phenomena that demand at- 
tention, and while it often terminates the existence 
of previous illness, it may also be the commence- 
ment of various afflictions. 

In some parts of the country there is a sort of 
proverb that women who have previously been 
weakly become healthy and robust, while those who 
had before been healthy and strong now become 
sickly. While in some the climateric change does 
not occasion any symptoms requiring attention, in 



DISEASES OF WOMEN. 305 

others serious consequences develop that tax the 
skill and tact of the physician. Too often these 
phenomena are passed without attention or the 
symptoms are referred to as the "turn of life" and 
the woman told she must wait until this period has 
passed before she can expect to be better. Not only 
does this refer to the sympathetic phenomena aris- 
ing from the arrest of a physiological function, but 
to pathological conditions that develop independ- 
ently of it. 

The suffering endured at this time is too often 
regarded as a sort of necessary affliction and is 
passed as a "must be,"* while the truth is, nothing is 
farther from right, for the more attention we give to 
the modification of symptoms, the arrest of disease 
and the preservation of the health at this time, the 
greater will be the chances for the enjoyment of 
perfect health afterwards. 

From fifteen to forty-five, sooner or later, according to the pe- 
culiar vivacity and vital staoiina of the patient, she has menstru- 
ated regularly, and now the germ production has gone forever. 
There is no longer the monthly periods ; the ovaries have ceased 
to produce germs ; but, though this has happened, the affections 
of the soul have but matured ; her power to love remains in full 
force and ardor, and also the desire and capacity for sexual en- 
j oyment. Some women continue beautiful and attractive until 
they are seventy. The cessation of the menses at this period is 
a wise provision of nature, for, if women went on producing 
offspring till a ripe old age, the result would be a puny race. 
The generative power disappears as she passes the period of 
maturity, and women who have borne children have a compen- 
sation for their privations and cares. — Buchanan. 

This period is ushered in in various ways. Men- 



306 PAINLESS CHILDBIRTH. 

struation seldom ceases all at once unless some acci- 
dent occurs by which it is arrested. It usually 
becomes more or less irregular. It may recur too 
frequently, or it may be delayed several weeks 
or even months, and then return too profusely — 
perhaps be regular a few times and then cease 
altogether. There is usually lassitude, debility, 
headache, nervousness, aching in the back and 
limbs, flashes of heat, deranged secretions, dyspep- 
sia, etc. 

Temperament modifies symptoms materi- 
ally, but the flashes of heat are present in nearly 
all cases. Plethora or anemia develops. The blood 
itself, no doubt, undergoes some change, a host of 
symptoms are present. She becomes fanciful, even 
hysterical ; she imagines everything ails her, and 
this morbid imagination often leads to her neglect. 
That class of symptoms termed "nervous" prevail?, 
producing an endless variety of phenomena, dis- 
tressing to the patient and annoying to her family. 
Mental aberation often occurs. The patient suffers 
both mentally and physically. 

The treatment for obvious reasons must be consid- 
erably varied. A wide range of conditions may 
be developed each of which may require to be met 
and subdued. Whatever function is deranged, 
whatever organ suffers, should receive attention. 
The hygenic measures already advised for various 
ills will contribute more or less to the establishment 
of a healthful condition. 



DISEASES OF WOMEK. f>37 

Plethoric women suffer from rush of blood to the 
head, vertigo and frequent attacks of hemorrhage. 
They make blood too fast. They need spare diet, 
exercise and if the bowels are sluggish saline ca- 
thartics, they bear purges well ; then if the circu- 
lation is excited give veratrum, a drop of the fluid 
extract in water every hour or two. Such cases 
generally derive much benefit from bromide of 
potash in infusion of squaw vine ; ten grains of the 
bromide in an ounce of the infusion three or four 
times a day is good treatment. 

If anemia prevails the blood gets impoverished, 
is thin and watery, is not manufactured fast enough 
to supply the waste, there will be headache, etc., 
etc , we must give tonics and nervines, and avoid 
excitement. An infusion of the squaw vine and 
ladies' slipper in tablespoonful doses three or four 
times a day is excellent; alternate with the muri- 
ated tincture of iron ten drops in a tablespoonful 
of syrup three times a day. 

If the bowels are irregular the remedies already 
mentioned may be employed. 

Displacements are often annoying with all the 
rest. 

The kidneys and skin must be kept active. 

The infusion of squaw vine probably fills as 
many or more indications than any other remedy 
and suits nearly all cases. It may be used alone or 
combined with other agencies such as the cohosh, 
lady slipper or senecio. The range of probabilities 



303 PAW-LESS CHILDBIRTH* 

being so great, an 1 complications so numerous, my 
space will only admit of generalizing the treatment. 
Should cases arise that do not yield to these reme- 
dies I will advise more specifically. Yet if these 
directions are followed such necessity will seldom 
occur. 

UTERINE STRICTURE. 

As a result of inflammatory disease, non-develop- 
ment or the improper use of caustic applications, 
the -canal leading to the cavity of the uterus is 
sometimes narrowed to such an extent that it may 
cause the most terrible dysmenorrhea on the one 
hand, or absolute sterility on the other ; the pas- 
sage being too small to allow the exit of the 
menstrual discharge, or admit the sperm cells. 

The consequences of this condition have already 
been alluded to in the consideration of sterility and 
mechanical dysmenorrhoea, and operate by closing 
the canal, though differently from flexion and 
polypi. The symptoms are very similar to those 
trouble?, but can only be determined from them by 
a careful exploration. 

The treatment consists in dilating the passage 
with bougies, tents, etc., or in an operation dividing 
the stricture. 

Dilatation usually succeeds temporarily, 
but is not apt to give permanent results, owing to 
the disposition of the stricture to contract again. 
Division when skillfully performed is more perma- 
nent. The operation is effected with instruments 



DISEASES OF WOMEX. 309 

for the purpose, but requires great care after its 
performance to render it successful. If the incised 
surfaces are allowed to come in contact they are 
very apt to unite and render the trouble worse than 
before. The operation itself is accompanied with 
little danger, but must be attended to daily for some 
time or failure results. It should never be under- 
taken by anyone other than a qualified physician 
provided with all the necessary facilities for effect- 
ually executing all the various steps of the opera- 
tion and the subsequent treatment. 
VAGINISMUS. 
Professor Sims applied this name to a spasmodic 
sensitiveness of the vagina. It occasions in many 
cases the most intense agony when anything is 
brought in contact with it. The existence of such 
an impediment to the consummation of marriage 
often gives rise, and many times unjustly, to do- 
mestic unhappiness, jealousy, divorce or suicide. 
There is nothing more certain than that the woman 
afflicted with it suffers exceedingly. It may exist 
in the unmarried or be developed after marriage. 
It is usually due to inflammation of the vagina, or 
to sexual debauchery. Tilt says : 

I have seldom known this state to exist except as a symptom of 
vaginitis or of chronic metritis ; and, like Scanzoni, b}- treating 
these complaints I have been able to cure spasmodic stricture of 
the vagina. There is no doubt in my mind, that in some of 
these cases the man is more at fault than his mate. 

A complete discussion of the subject, however, is 



310 I'AINLESS CHILDBIRTH, 

scarcely appropriate in a work of this kind. I will, 
however, on application by the afflicted, explain the 
matter more fully and advise as the case presenting 
may demand. 

Tilt, Sims, Hood and many others have resorted 
to forcible instrumental dilatation to overcome the 
trouble, applying it under anesthesia, 

The first step seems to be to ascertain if there be 
inflammation present and if so, cure it, when the 
morbid sensitiveness will usually yield. There is no 
need of the suffering experienced from such cases, 
for it will yield to proper treatment ; but for the 
reasons mentioned above twill refrain from farther 
discussion of the subject 

THE OVARIES. 

Situated in the cavity of the pelvis, at either side 
of the uterus, communicating with it through the 
fallopian tubes, are two small organs, analogous to 
the testis in the male, called the ovaries, In them 
the germ cells are developed and when matured are 
passed through the fallopian tubes to the uterus and 
unless arrested there are expelled, The completion 
of this process occasions the phenomena of men- 
struation. If, however, the sperm cells of the male 
come in contact with the germ cell under favorable 
circumstances during some part of the passage from 
the ovary to the womb conception occurs. 

It is truly wonderful the influence these little 
organs exert upon the life and happinesss of woman. 



DISEASES OF WOMEN. 311 

An author in endeavoring to illustrate their im- 
portance has said : 

It would seem as if the Almighty had taken two ovaries and 
"built up a human being around them. 

These organs are liable to congestion, 
inflammation, neuralgia, enlargement, dis- 
placement, or may be the seat of tumors that 
grow to enormous size. They are influenced by 
colds, self-abuse, sexual excesses, uterine disease 
and displacements. 

Either as a cause or effect, the ovaries in women 
who suffer from derangement of menstruation be- 
come swollen, painful and tender; They can often 
be felt when swollen, except the women be fleshy, 
through the walls of the abdomen, inside and just 
below the points of the hips. 

The congestion often gives rise to the most in- 
tense pain, not unfrequently causing spasms, hys- 
terical phenomena, etc. Menstruation may be 
deranged and is apt to be profuse, the sufferer be- 
comes weak, anemic, nervous, fretful. Sexual de- 
bauchery predisposes to these troubles, and is often 
the cause of the most intense neuralgia. Women 
of nervous temperament are most subject to these 
affections. I have seen the most troublesome- men- 
strual disorders occasioned by congested ovaries ; 
the menses were profuse and recurred every two 
weeks, resisting all treatment until the cause was 
discovered and treatment addressed to its removal. 






312 PAINLESS CHILDBIRTH. 

Usually one ovary is affected though both may be. 
The congestion may persist for a long time, being 
worse just before menstruation, disappearing after 
the flow has well begun, to reappear again at the 
next period. The location of the pain and sore- 
ness will usually be sufficient to indicate the 
trouble. 

Begin a week before the expected trouble and 
take a teaspoonful three times a day of the follow- 
ing : 

Tincture Belladonna, ... 5 drops. 
Water, ...... 4 ounces. 

Mix. At the period it may be taken every two hours. 

In the interval measures to improve the general 
health and the avoidance of all sexual excitement ; 
sitz baths, outdoor exercise and the following : 

Bromide of Ammonia, - - 4 drams. 

Quinine, 30 grains. 

Tincture Cinchona Compound, - 1 ounce. 
Syrup of Orange, - 3 ounces. 

Dose — A teaspoonful three times a day. 

In inflammation of the ovaries there will be 
fever ushered in with chills, pain in the ovarian 
region extending over the whole abdomen, quick 
pulse, restlessness and general symptoms of inflam- 
mation. 

Apply mustard, followed by hot applications to 

the abdomen, and hot foot baths. Then give : 

Tincture of Aconite, - 10 drops. 

Tincture of Gelseminum, - - 30 drops. 

Water, 4 ounces. 

Mix. Dose — A teaspoonful every two or three hours. 



DISEASES OF WOMEN. 313 

If it occurs at the time when menstruation 
should appear, let an infusion of serpentaria, or Vir- 
ginia snake root as it is generally called, be drank. 
It will usually cause sweating. It may be combined 
with motherwort in a small quantity At the same 
time alternate the fever mixture above mentioned 
with drop doses of pulsatilla every two hours. 

Do not give cathartics or forcing medicines, until 
the inflammation has subsided. 

A consideration of ovarian tumors in a work of 
.this kind could be of no use to the general reader, 
and will be omitted. I need scarcely remark that 
diseases of the ovaries are not yet thoroughly un- 
derstood, but attention having been drawn to them 
by a few noted physicians, doubtless the time is not 
far distant when a definite knowledge of the 
changes they undergo during life, will enable the 
profession to cure diseases that now resist their at- 
tempts. 

THE BREASTS. 

Next to facial beauty does woman pride herself 
on a proper development of her breasts. If too 
large or too small, they render her figure imperfect 
and materially impair her attractiveness. 

Not only is perfection here essential to beauty 
and happiness, but it is also necessaiy for the per- 
fect performance of that function to which all true 
women aspire — maternity. 

But, alas ! these organs so doubly essential to the 
healthy happiness and usefulness of women x are 






314 PAINLESS CHILDBIRTH. 

prone to disease. They may be arrested in 
their development, or after having been devel- 
oped, they may undergo retrograde metamorphosis 
and become shrunken, shrivelled, unsightly ; de- 
velopment may proceed so far that they become 
too large and burdensome. They are often the seat 
of tumors, cancers, etc. Again they are liable to 
inflammation and abscesses. 

Any departure from a natural size and firmness 
constitutes a disease, and may as appropriately be 
regarded so and subjected to proper treatment as 
any other organs, that more intimately influence 
the processes of life. 

The breasts are properly to be considered as a 
part of the reproductive system, and menstrual 
and uterine diseases are often manifested by dis- 
eases of the breasts. In fact uterine disease is, in a 
large proportion of cases, manifested by wasting 
of the breasts. 

During lactation (nursing) they are extremely 
liable to inflammation, and if this is not 
promptly arrested, abscess results. Cold, blows, or 
irregularity of having the milk ducts emptied, are 
the most frequent causes. It usually begins with 
chills and fever, darting and shooting pains, ten- 
derness, hardness, and as the swelling increases it 
becomes a dusky red color. Throbbing is a promi- 
nent symptom as the abscess is forming. 

Treatment should be begun early. Apply oil of 
peppermint, and if the breast is large, and its own 



DISEASES OF WOMEN. 3 15 

weight causes pain, support it by a well adjusted 
bandage. The following is also excellent as an 
^application : 

Tincture of Belladonna, - - 1 ounce. 

Tincture of Camphor, - - - 1 ounce. 

Essence of Peppermint, - - - 1 ounce. 
Mix. Apply three or four times a day. 

Internally give ; 

Tincture of Aconite, - 10 drops. 

Tincture or Fluid Ext. Poke Root, - 30 drops. 
Water, - 4 ounces 

Dose — A teaspoonful every hour or two. 

If this does not act promptly, or is begun too 
late an abcess is likely to form. When such is the 
case, it should be opened as soon as fluctuation can 
be detected. Don't open it too early, nor delay too 
long. If too early, it is apt to develop erysipelas ; 
if delayed, unnecessary suffering occurs. Usually 
there is little danger to life from mammary abscess, 
but the suffering a woman endures may make a 
serious impression on her health. My mother was 
laid in an untimely grave by an abscess of the 
breast. 

After the abscess has been opened, it should be 
dressed with warm poultices, of which slippery elm 
is the best, or patent lint to absorb the discharge. 
Measures to support the general health should be 
looked after ; tonics if need be. If the health has 
been badly affected, it may be advisable not to per- 



81 G VAIN LESS CHILDBIRTH. 

mit the child even to nurse from the sound breast, 
lest the two drains be more than the mother's con- 
stitution will bear. 

Atrophy, or non-development of the breasts, like 
other diseases, admits of a cure, and women whose 
forms are imperfect and who habitually resort to 
artificial means, can have the defect overcome by a 
proper course of treatment. The cause must be 
considered, and the relation of the wasting to the 
other diseases must be studied, and such treatment 
devised as shall bring about the most perfect state 
of the general health, then remedies to increase 
the nutrition and cell development locally, will 
succeed in all cases. 

The matter has received much attention during 
the past few years, and several remedies found to 
exert an efficient curative influence over this con- 
dition. I will, however, omit explaining them, 
because were I to do so it would open a field for 
quacks to operate in, who would take advantage of 
woman's desires to be attractive, and flood the 
country with nostrums that would necessarily dis- 
appoint as many or more than were gratified. 
There are no specifics. We must consider condi- 
tions present and apply the remedies in accordance 
with those physiological and therapeutic laws that 
govern scientific treatment in other diseases. 

The strong disposition of cancerous disease to 
locate in the female breast, necessarily causes alarm 
at the discovery of any bunch or tumor in this 



DISEASES OF WOMEN. 317 

locality. The diagnosis is not easy except when the 
disease is well advanced, and physicians often find it 
difficult to distinguish between benign and malig- 
nant tumors. A few points, therefore, may not be 
amiss. The form of cancer found here is generally 
very hard, and is frequently called stone cancer in 
common parlance, while in professional language it 
is Scirrhus. It is very hard, knotty to the feel, there is 
darting, gnawing, lancinating pain, and when well 
advanced becomes immovable, the surface discol- 
ored, the nipple drawn backward into the mass, the 
glands in the armpit enlarge, and the whole com- 
plexion gradually develops that peculiar waxy, 
sallow hue known as the cancerous cachexy. On 
the other hand, benign tumors do not present these 
characters, but may become much larger than a 
real cancer. 

The treatment is surgical — extirpation. While 
there need be no undue haste, the matter is one that 
is not to be neglected until the whole system is im- 
pregnated with cancer cells. If there is no pain 
or soreness, take time and do not be scared into do- 
ing what will do no good. If it presents the char- 
acteristics of cancer, early removal is advisable, 

The consideration of cancer, however, is ,not 
within the intention of this work, and though my 
space has necessitated the curtailment of many sub- 
jects, it is the earnest hope of the author that the 
hints expressed will point many who are in search 
of health to the recovery of that desirable boon. 



313 PAINLESS CHILDBIRTH. 



CHAPTER XIII. 



DISEASES OF CHILDREN. 

Mortality — Gradation of Doses — General Signs— The Counte- 
nance — Attitude and Gesture — The Cry — The Discharges — 
The Circulation — The Temperature — Odors — The Tongue, 
Excoriations and Ulcers — Vomiting — Convulsions — Apthse 
— Colds — Influenza — Croup — Pneumonia — Chronic Pneu- 
monia — Consumption — Asthma — Whooping Cough—Mumps 
— Sore Throat — Quinsey — Diphtheria — Cerebro-Spinal Men- 
ingitis — Small Pox— Chicken Pox — Measles — Scarlet Fever 
— Erysipelas — Diarrhoea — Dysentery — Acute Intestinal Ca- 
tarrh — Cholera Morbus — Cholera Infantum — Ephemeral 
Fever — Worms. 

Children are subject to various disorders, the lia- 
bility to at least some of which diminishes as they 
advance in age. It is estimated that fully one-fourth 
of all the children born, die before reaching their 
seventh year. 

To know what to do before the arrival of the 
family physician, or in his absence, is often of very 
great advantage, and the writer hopes his sugges- 
tions may be of practical value to the anxious 
parent, and an aid to the physician in the perform- 
ance of his many duties. 

As the unprofessional reader will derive little or 
no benefit from pathological considerations, I shall 
omit them almost entirely, and, instead of pursuing 



DISEASES OF CHILDREN. 319 

the usual arrangement of diseases by groups and 
classifying them according to their pathology, I 
shall consider them in a manner that seems to me 
to be of the greatest convenience to the reader, 
endeavoring to render the subject as intelligible 
and practical as brevity will permit. 

Unless otherwise specified, the doses advised in 
this chapter will be for children from one to four or 
five years of age, and should be increased for those 
older, adding about half as much more for children 
between five and ten, double from ten to fifteen, and 
treble for adults. This plan will be rather more 
convenient than the old one of graduating the 
dose by years from one to twenty-one, particularly 
as I do not intend to prescribe remedies in such a 
manner as to endanger life by the difference of a 
fraction of a dose. 

It requires not a little tact and discrimination to 
properly investigate the disorders of childhood par- 
ticularly among very young children. We are 
compelled to depend upon signs almost entirely. 
These should be well understood by the mother or 
nurse, for the attending physician must derive his 
information largely from those who are constant- 
present, and as many of these signs only appear at 
-intervals, a habit of observation should be acquired 
that every sign may be noted at its occurrence. 
GENERAL SIGXS. 

Among the sources from which information may 
be obtained in children who can not convey a 



320 PAINLE8S CHILDBIRTH. 

knowledge of their condition by speech, are the 
countenance, gestures, attitude, breathing, circula- 
tion, sleep, cry, discharges, skin, temperature, odors, 
the tongue, aggravations, etc. We are to make use 
of our senses, see, hear, feel, and, even smell ! Some 
diseases generally appear at certain seasons of the 
year. The prevalence of epidemics should put us 
on our guard. 

The expression of tha countenance varies 
with the stages of the disease, as well as in different 
diseases. In affections of the brain and nervous 
system the forehead is contracted and heavy, the 
brows knit, the eyes vacant, expressionless, or wild, 
staring, fixed, sometimes squinting, bloodshot, half 
open, dropping of the lids, the pupils contracted in 
the early stages of the disease, and dilated later on ; 
the face is generally hot and flushed, spasmodic 
drawing of the features in twinges of pain. Some- 
times the upper lip will be drawn tightly over the 
teeth and perhaps be almost livid. 

In diseases of the liver, the skin and eyes become 
yellow, and sodden. 

In worms, and intestinal irritation from other 
causes, the nose and upper lip are apt to be swollen, 
the white of the eyes of a pearly cast, a sharp white 
circle around the mouth, and if fever is present the 
rest of the face flushed. 

In bowel diseases the cheeks are sallow, sunken, 
mouth compressed and the lips drawn, dry, dark, 
parched, m$ as the disuse progressqs, wsiety. 



• DISEASES OF CHILDREN. 321 

emaciation, the chin prominent, the eyes sunken 
and hollow; if not stupid, the whole features sharp; 
as exhaustion comes on the face is alternately 
flushed and pale, hot and cold ; and in the latter 
stages the face is glistening, pale, cold, eyes sunken, 
half closed, lips parched and the features pinched. 

In diseases of the respiratory organs as pneumonia, 
bronchitis, etc , the face is flushed, dusky red, nostrils 
working, dilating with each inspiration, and con- 
tracting with each expiration,' the s brows knit, lips 
livid, sharp dark circle around the mouth, and in 
advanced cases, emaciation, etc. 

In measles the whites of the eyes are red, the eyes 
watery, overflowing, squinting, avoidance of light, 
the lids swollen, and the general appearance as if 
crying. 

In scarlet fever the eyes are often red and watery, 
but never overflow, and give the appearance of cry- 
ing, as in measles, and the intolerance of light is 
not so marked. 

In chronic diseases the face pales and flushes at in- 
tervals, the eyes sunken, and pupils dilated, with 
circles beneath, the whites muddy, the cheeks hol- 
low, particularly in diseases of the nutritive organs, 
sunken, complexion sallow. In diseases of the lungs, 
the cheeks are sunken, emaciated, pale with a cir- 
cumscribed redness, the eyes often unusually bright. 

The attitude and gestures aid in indicating 
the location and character of the disease. Early 
there will be inattention to surrounding objects, 



322 PAINLESS CHILDBIRTH. 

languor, or restlessness In inflammatory diseases of 
the chest and abdomen motion will be avoided as 
much as possible, the position on the back with the 
knees bent and drawn up, sharp cries as there is 
sudden twinges of pain. As a rule the pain of in- 
flammation causes the child to lay very stfll. Spas- 
modic pain causes the child to start in terror and 
writhe and twist about as the muscles are caused to 
suddenly contract. In convulsions the head is. thrown 
backward, the eyes roll upward, the hands clenched, 
an arm becomes rigid, a leg drawn upward, the toes 
are drawn downward, the thumbs drawn into the 
palms of the hands, the child starts or screams, or 
perhaps becomes unconscious, the breathing is spas- 
modic, perhaps frothing at the mouth, gnashing or 
grinding the teeth. 

In inflammation of the brain or its membranes the 
head is rolled from side to side as the child lies on 
its pillow, the hands make sundry motions in dif- 
ferent directions, and are frequently raised to the 
head, clutching at the hair or cap as if endeavor- 
ing to tear them away. 

In diseases of the mouth, teething, etc., it works at 
the mouth, bites, throws itself, rubs the gums, etc., 
and may have convulsions. 

In croup and other suffocating diseases the hands 
clutch at the throat press it from side to side ; the 
child struggles to maintain the upright position, 
with the head thrown back to favor the entrance of 
air into the lungs. 



DISEASES OF CHILDREN 323 

The cry is indicative of displeasure, uneasiness, 
or pain In affections of the lungs it is a sort of a 
groan- In croup it is a hoarse, peculiar, metallic or 
crowing sound In acute diseases of the brain it is 
one single, sharp, powerful cry at distinct intervals, 
In diseases of the boiuels it is a low moaning sound. 
Shedding tears during a sickness is regarded as a 
favorable sign. 

The discharges should always be noted. They 
may be scanty, excessive or perverted When there 
is vomiting, it should be noted to see if it is sour, 
thick, watery, clear, opake, yellow or green, or if it 
contains food. Improper food is often got rid of by 
vomiting, or passing onward into the bowels it 
creates colic or diarrhoea. Diseases of the stomach 
are often characterized by vomiting, when it may 
contain the undigested food, mixed with other 
matters. Yellow r or greenish discharges indicate the 
presence of bile. Vomiting is nature's provision 
for the removal of an excessive amount of fpod in 
infancy. In cholera infantum the vomiting is per- 
sistent, watery, and mixed with the food. It is one 
of the first symptoms of some eruptive fevers, and 
often terminates a paroxysm of whooping cough. 
Diseases of the brain, and injuries to the head may 
cause vomiting. 

The stools if frothy, sour or green, indicate derange- 
ments of digestion, and are generally attended with 
griping. Slimy stools are usually present during 
teething, and when worms are causing trouble 



324 FAINLESS CHILDBIRTH, 

Blood and mucus indicate dysentery Thin, often* 
sive stools, varying in coJor from light to dark, are 
the principal characteristics of diarrhoea, and clay 
colored discharges indicate deficient action of the 
liver. The frequency of the stools should be ob- 
served for even though they present no unnatural 
appearance, if too frequent they indicate defective 
appropriation of nourishment and are apt to contain 
undigested food. 

The urine is scanty, highly colored, has a strong 
odor, and is generally loaded with a bran like sedi- 
ment in fevers, inflammations and rheumatism. 
The quantity, color and smell may be ascertained by 
observing the diapers of children too small to use a 
urinal. In diabetes it is clear and profuse. In nerv- 
ous disorders it is apt to be profuse, and on standing 
deposits a dirty whitish sediment, and soon becomes 
offensive. In diseases of the bladder, it will be passed 
often and but little at a time. In affections of the 
liver it will have a yellowish or saffron color. 

The circulation in infancy is more variable 
than in adults, the pulse more rapid, and easily in- 
fluenced, and is not as reliable as a diagnostic 
means in infants as in grown persons. 

The skin and its temperature are influenced by 
disease. It is hot and dry in fevers and inflamma- 
tions ; cool and moist in constitutional weakness. 
Profuse sweating with cold clammy skin indicates 
debility. A doughy, inelastic skin is apt to be pres- 
ent io tubercular or scrofulous affections, It is 



DISEASES OF CHILDREN. 325 

yellow in jaundice, sallow and sodden in diseases 
of nutrition. A bluish tint points to structural 
disease of the heart. It is red in fevers and eruptions, 
purplish or livid when the blood is imperfectly 
oxygenated, and dry and harsh in diabetes, and 
Bright's disease. 

The temperature has of late years become an 
important aid to diagnosis, and furnishes moder- 
ately reliable indications of the probable result. 
In health it is about 98^° Fahr. and any persistent 
or considerable deviation from this standard denotes 
disease, and the greater the rise the greater the 
danger. The temperature can only be determined 
by a thermometer designed for the purpose. As it 
sinks below the natural standard, during the pro- 
gress of a disease it indicates danger of collapse, 
though in diabetes it is usually one or two degrees 
lower than in health. It rises in fevers and inflam- 
matory diseases, and if the rise is persistent shows 
there is severe illness and danger. When it rises 
to, or above 106° recovery is rare, unless the rise is 
only temporary. 

Odors are not easily described but a knowledge 
of them serves a very useful purpose. In measles 
or small pox, there is a peculiar smell that once 
observed will seldom be forgotten. In lung diseases 
a yeast like odor is often present. In stomach and 
liver diseases the breath is sometimes very offensive. 
A peculiar smell accompanies fevers. In rheuma- 
tism the perspiration is usually sour, When the 



326 PAINLESS CJIILDBIBTIL 

stools have a sickening, cadaverous odor during any 
disease it indicates danger. Urine during pro- 
tracted fevers, inflammations, etc., may have an 
ammoniacal odor, and indicates danger. 

The tongue furnishes the intelligent practitioner 
with a vast amount of information. In health the 
mouth is moist and pale, the tongue moist, pale, and 
partially covered with whitish mucus. When 
loaded with whitish curdy matter there is generally 
disturbance of digestion. A dry tongue is common 
in most febrile diseases. If it becomes moist after 
having been dry and furred it is favorable. It is 
fissured in typhoid fever. Eedness and dryness is 
present in inflammatory diseases of the alimentary 
canal ; in the eruptive fevers it is very red ; it also 
indicates acute indigestion. A heavy fur shows 
disease of mucus membranes ; and if yellow, dis- 
ease of the liver ; and a brown or black fur, a low 
state of the vital forces, and if dry, danger. A 
large, pale, flabby, tongue indicates debility and 
tardy retrograde metamorphosis. A heavily coated, 
moist tongue indicates derangement of the secre- 
tions without inflammation. Eedness of the tip and \ 
edges of the tongue indicates irritation of the stom- 
ach or upper part of the intestines. Gradual clearing 
of the tongue during disease indicates a tendency to 
to recovery. If the tongue becomes browner, drier, 
dirtier each day, and the nervous system more feeble, 
the hope of recovery fades. When the fur comes off 



DISEASES OF CH1LDBEX. 327 

suddenly or separates in patches, leaving a glossy 
surface beneath, it is unfavorable. 

Although the foregoing indications are not as 
complete as if this work was intended mainly for 
the guidance of physicians, and admit of many ex- 
ceptions, they furnish many valuable guides to the 
recognition and location of diseases — an outline to 
diagnosis — as will be observed in the consideration 
of the following diseases. 

EXCORIATIONS AND ULCERATIONS. 
Without the greatest attention to cleanliness 
children are apt to get chafed behind the ears, in 
the wrinkles of the neck and groin, and about the 
arms. This causes the child untold suffering, and 
unless it receives proper attention is apt to degen- 
erate into more or less extensive ulcerations. s 

Treatment, — The prompt removal of discharges 
and carefully washing and drying the child will go 
far towards obviating this trouble, yet in fleshy 
children, this alone may not be sufficient, and addi- 
tional means will be required. Bathe the irritated 
parts with warm milk and water, rejecting the com- 
mon coarse soaps of commerce, and after drying 
carefully with a soft cloth, sprinkle with powdered 

.' starch, and lay into the folds of the skin a bit of 
scorched linen rag. Dusting the parts with pow- 

f dered lycopodium, which can be got at any drug 
store, is also an excellent means of preventing seri- 
ous ulcerations, giving almost instant relief in 
chafes. When the trouble is persistent, bathing 



328 FAINLESS CHILDBIRTH. 

the raw surfaces with an infusion of golden seal is 
a very reliable remedy. The strength of the infu- 
sion should be a teaspoonful of the powdered root 
in half a pint of water ; after standing a few hours, 
strain. To this we may add a little borax, or in 
some cases 10 grains of sulphate of zinc will do 
better. 

In children of a scrofulous habit there is a dispo- 
sition in such cases to form extensive sores, and 
attention to the child's general health becomes nec- 
essary. We must see that it receives proper nour- 
ishment and then give some alterative as : 

Compound Syrup of Stillingia, - 4 ounces. 
Fluid Extract of Bayberry, - J^ ounce. 
Dose — One- fourth to one-half teaspoonful three times a day. 
At the same time continuing the lotion of golden seal and zinc. 

If this does not cure, in a reasonable time, it 
might be well to substitute Peruvian bark for the 
golden seal and prepare and use it in the same 
manner. 

VOMITING. 

Vomiting is often caused by over feeding, and is 
one of nature's methods of disposing of surplus 
food, When it results from this cause careful mod- 
eration of the quantity of food will generally be all 
that is required. 

For the most part vomiting is symptomatic of 
other diseases, though it may exist as a disease 
itself. 



DISEASES OF CHILDREN. 329 

When it occurs in dyspepia the food is usually 
undigested, in a state of fermentation, and the 
bowels deranged. In such cases the bowels require 
some laxative, or we may put five drops of the fluid 
extract of nux vomica in a glass of water and give 
a teaspoonful every three or four hours. It exerts 
an excellent influence in many cases of chronic 
constipation in children and adults. In connection 
with this give two grains of pepsin and a half a 
grain of sub-nitrate of bismuth either just before 
or after the meal. 

Ordinarily, five drops of the tincture of ipecac, in 
a glass of water given in teaspoonful doses every 
hour or two will control vomiting, particularly if 
associated with a looseness of the bowels. 

Ii the tongue has a yellow coating or there is a 
yellowness around^ the mouth, alternate the ipecac 
with the nux vomica, prepared as for dyspeptic 
vomiting. 

If the vomited matter is sour, dissolve a teaspoon- 
ful of bicarbonate of soda in a glass of water and 
give in sips every half hour till the acidity is cor- 
rected, continuing the nux vomica. 

A plaster composed of allspice, cloves, and cin- 
namon, or ginger and Peruvian bark, applied over 
the stomach is an excellent auxiliary means- but is 
not to be left on too long on account of the irrita- 
tion of the skin it may cause. 

When vomiting occurs as a symptom of some 
other disease, the treatment recommended for that 



330 PAINLESS CHILDBIRTH. 

will be most appropriate, though the temperary use 
of the means just considered may become necessary. 

CONVULSIONS. .. 

Spasms or fits, as convulsions are often called, may 
arise from a variety of causes. They may be symp- 
tomatic of disease of the brain or nervous system, 
but as generally met with in children they are 
caused by irritation reflected to the brain from differ- 
ent parts of the body. In this way they are caused 
by the presence of worms in the intestinal tract, by 
indigestible food, acidity of the stomach, flatulence, 
retention of urine, surface irritation, the striking 
In of some eruption, etc. The eruptive fevers often 
commence with a convulsion. The younger and 
more irritable the child, particularly if of a highly 
nervous temperament or scrofulous constitution , the 
greater its liability to fits from intestinal irritation. 
Convulsions are always to be regarded with appre- 
hension. 

The symptoms vary in duration and severity, 
lasting from a few minutes to several hours, and the 
attack may be repeated at indefinite intervals. 
There is sudden and involuntary jerking of the 
extremities, twitching of the muscles of the face 
grating the teeth, rolling the eyes, perhaps frothing 
at the mouth, the thumbs drawn into the palms of 
the hands, and the hands clenched, and the toes 
drawn downward. The pulse may be accelerated, 
and irregular, small, or hard, and the face flushed. 



DISEASES OF CHILDREN. 331 

The contents of the bowels or bladder may be ex- 
pelled, and consciousness may be wholly or par- 
tially lost. The premonitory symptoms, twitching 
of the face, grinding of the teeth, without actual 
convulsions are often denominated inward fits. 

In the treatment we must be governed by the 
cause as far as possible. If the premonitory symp- 
toms are noticed, or if the child can swallow, give 
a few spoonfuls of salt and water. It is always at 
hand, and is an excellent remedy. It may be given 
freely, for it will only cause vomiting if more than 
is necessary be taken, and this is often desirable. 
Put the feet in hot mustard water, and if the head 
is hot and the face flushed, apply cloths wet in cold 
water to the head. 

The inhalation of a few drops of chloroform or 
ether, from a napkin held near the nose, almost 
always affords relief, 

When the convulsions are caused by the irritation 

from teething and the gums are hot and swollen, 

lance or scarify them freely, and give a teaspoonful 

of the following every hour : 

*Tincture of Gelseminum, - - J^ dram. 
Bromide of Potassium, - - - 1 dram. 
Water, 2 ounces. 

Discontinue it when the fit is broken, or continue 
it in smaller doses every three or four hours. 

When due to worms give the salt and water 
already mentioned, pumpkin seed tea, or 10 drops 

* Ten drops of the fluid extract of gelseminum may be substituted 
lor half a dram of the tincture, if the tincture is not at hand. 






332 PAINLESS CHILDBIRTH, 



of turpentine in a teaspoonful of castor oil, increas- 
ing the dose for a child over three years old. Fol- 
low this with the treatment laid down under the 
head of worm c , which see. 

If the fit is caused by irritation of the stomach or 
bowels from indigestible food, give an emetic of 
ipecac or lobelia, 10 or 15 drops in warm water and 
repeated every 15 minutes till free vomiting ensues. 
One half a teaspoonful of ground mustard in a cup 
of warm water given part at a time is a very 
prompt emetic and almost invariably at hand. 
Follow the emetic with a dose of castor oil to move 
the bowels, or the neutralizing mixture, mentioned 
in the latter part of this book. 

If the stomach is sour give the neutralizing mixt- 
ure, or if not at hand put a teaspoonful of bicar- 
bonate of soda, or saleratus in a gill of water and 
give it in tablespoonful doses every 10 or 15 min- 
utes. Attention to the bowels is necessary, and as 
the neutralizing mixture accomplishes both pur- 
poses it is preferable. 

A highly sensitive condition of the nervous sys- 
tem predisposes to fits, and the gelseminum and 
bromide of potash, already mentioned, will be found 
an excellent remedy to modify this condition and 
thus prevent the fits, but attention to the removal 
of the causes is necessary and must not be for- 
gotten. 

When the convulsions are due to the sudden 
striking in of some eruption, use the warm bath at 



DISEASES OF CHILDREN. 333 

once, and be careful, in removing the child from it, 
that a chill is not experienced. At the same 
time give : 

Tincture of Aconite, ... 5 drops. 
Tincture of Belladonna, - - - 5 drops. 

Water, 6 ounces. 

Dose — A teaspoonf ul every half hour to one hour. 

Call the family doctor in the mean time, as the 
troubles are sometimes complicated and need com- 
bined treatment. 

APTILE. 

Apthae, thrush, or canker as it is often called, is 
largely due to a faulty condition of nutrition, indi- 
gestion, bad, unwholesome food, and often follows a 
protracted diarrhoea. It is piost common among 
pale, delicate or unhealthy children, and those 
brought up by hand, or those whose hygienic sur- 
roundings are defective. 

The symptoms consist in the appearance of 
small white specks in the corners of the mouth and 
upon the tongue, resembling bits of curdled milk, 
which are disposed to spread and multiply, extend- 
ing down the throat to the stomach, and in some 
cases the whole length of the intestinal tract. The 
mouth becomes hot and painful, the lips swollen, 
the saliva dribbling away. The child is feverish 
and restless, grasps the breast in its mouth and 
immediately lets go again, is fretful, cries with pain 
and gives other signs of suffering. The pulse is 



334 PAINLESS CHILDBIRTH. 

quick and feeble, a diarrhoea develops with greenish, 
watery stools, and emaciation follows. 

Treatment. — In the outset we must endeavor to 
prevent the extension of the disease, give attention 
to the surroundings, endeavor to obtain pure air 
and water, or if convenient a change of climate. 
If nursing, see that the mother's milk is wholesome, 
if not, seek to improve her condition, or else wean 
the child, secure a nurse or adopt artificial feeding. 
If brought up on cow's milk, see that the milk is 
sweet and good and the cow healthy. A change of 
food often accomplishes great results. Avoid acids, 
sweets, and fats. A little beef tea, mutton or chicken 
broth, soft boiled rice, oatmeal gruel, boiled milk, 
etc., varied a little are better in these cases than 
persistent nursing or feeding with milk. 

When the mouth is dry and the child feverish 
and thirsty, do not forget to give it a little cold 
water often ; it is as grateful in small quantities to 
the child as to an adult. 

To overcome the acidity, and regulate the bowels 
give small doses of the neutralizing mixture, and 
if the diarrhoea is exhausting add three to five 
drops of the fluid extract of cranesbill to each dose. 
Alternate -with : 

Fowler's Solution, .... 5 drops. 

Fluid Extract Baptisia, - - - 15 drops. 

"Water, - - - - - - 4 ounces. 

Dose — A teaspoonful every four hours, two hours from the 
doses of the neutralizing mixture when the symptoms require 
the use of that also. 



DISEASES OF 0SILDRE2T. 335 

If indigestion predominates, give a grain or two 
of pepsin and one-half a grain of subnitrate of 
bismuth after or immediately before each feeding. 

For local application in the mouth, many old 
fashioned remedies have had a time honored repu- 
utation, as an infusion of goldthread, sage and 
honey, borax and honey, alum and honey, etc. 

The following answers a good purpose, and if in 
using it a little is swallowed it is beneficial rather 
than otherwise : 

Boracic Acid, .... 20 grains. 

Fluid Hydrastis, - - - - i^ dram. 

Glycerine, - - - - - 1 dram. 

Water, - 2 ounces. 

Apply with a soft brush, touching the sores several times a 
day, or put one-fourth to one-half a teaspoonful into the mouth 
three or four times a day. 

A change to the following, after using one vial of 
the above, is often advisable : 

Carbolic Acid, 10 drops. 

Glycerine, 1 dram. 

Water, - 2 ounces. 

Mix, and apply with a brush. Permit one-fourth of a tea- 
spoonful, well diluted, to be swallowed three or four times daily. 

The disease is often met with in older children 
or adults. Then the same remedies increased in 
dose or strength will be equally appropriate. 
COLDS. 

Although most people regard a common cold 
with indifference, a writer has well said that u Colds 



336 PAINLESS CHILDBIRTH* 

destroy more lives than any other cause." They 
result from exposure in some way or other, and are 
too well known to require any description. All are 
liable. They may affect any or all parts of the 
body. Colds vary greatly in severity, and their 
frequent repetition, lays the foundation for severe 
and often fatal diseases. Indeed colds are the im- 
mediate cause of a large percentage of our diseases. 

Treatment-Colds should always receive prompt 
attention, for neglect is often fatal. Give a hot 
foot bath on going to bed and drink a cup of warm 
catnip, boneset or composition tea, cover warm and 
encourage perspiration, but be careful the next day 
not to renew the attack. A mild cathartic after the 
sweat will aid in breaking up the cold. Hot lem- 
onade at night has enjoyed a good reputation. 

Five to ten drops of aconite in a goblet half full 
of water, given in teaspoonful doses every half 
hour or hour until perspiration is established, is 
good treatment for either child or adult. An alco- 
holic, or spirit vapor bath is alway beneficial. 
INFLUENZA. 

Under this caption we consider the more severe 
forms of "cold" particularly such as affect the 
respiratory organs. Most writers consider influenza 
and colds together, but as influenza often appears 
in the form of an epidemic catarrh, and is usually 
so much more severe, I have separated them with 
the view to impress the importance of prompt and 



DISEASES OF CHILDREN. 337 

efficient treatment, for while the disease may not 
be fatal itself, it often lays the foundations for 
chronic nasal catarrh, bronchitis and even con- 
sumption. 

Symptoms. — An attack of influenza is generally 
ushered in with chilliness or rigors, lassitude, stiff- 
ness and soreness of the muscles, sneezing, a dry- 
ness or increased discharge from the nasal cavity, 
oppressed breathing, soreness of the throat, redness 
and watering of the eyes, the nose sore and swollen, 
thirst, etc. With these symptoms there is a fever 
of varying severity, which is apt to remit in the 
morning. The tongue is coated, the bowels de- 
ranged and the urine scanty and highly colored. 
A troublesome cough comes on, at first dry and 
irritable, which in time is followed by expectora- 
tion, the child snuffles, and in adults the secretion 
sometimes becomes so profuse, as to keep the per- 
son "hawking" or spitting all the time. There is 
more or less dullness of the intellect, headache, 
darting pain, and in some cases there may develop 
croup, bronchitis or pneumonia. 

Treatment, — In mild cases of influenza the 
symptoms will so nearly resemble a common cold, 
that unless an epidemic of the disease is prevailing 
it will be impossible to distinguish between them. 
The treatment advised for colds is appropriate in 
mild cases, but in severer ones a more thorough 
course may be necessary. An old fashioned do- 
mestic remedy of considerable efficacy, I well 



338 PAINLESS CHILDBIRTH. 

remember, in "childhood's happy hours/' consisted 
of vinegar, molasses and butter stewed together and 
taken hot on going to bed ; for an adult a large 
cupful was a dose. 

In the early stages of the disease a thorough 
sweat is decidedly appropriate, A spirit vapor 
bath (described elsewhere) aided by a hot mustard 
foot bath, and the warm teas advised for a cold, fol- 
lowed by the use of aconite as for a cold and pushed 
till the pulse is regulated and the fever controlled, 
will in nearly every case cut short the attack. As soon 
as the fever shows a distinct remission in the morning 
commence giving quinine every six hours, one-half 
a grain at a dose for a child two years old ; continue 
it two or three days in succession. Allay thirst 
with drinks of lemonade, flaxseed tea, or water. 

If the bowels are constipated, after the fever is 
under control and the pulse moderated, give some 
mild laxative, but always bear in mind to so time 
it that it will not be operating on the bowels when 
the patient is bathed in perspiration. 

If the symptoms of nasal catarrh predominate, 
powdered boracic acid, used as a snuff, will usually 
afford speedy relief, although it will sometimes 
cause an unpleasant sensation for a few minutes. 
Inhaling the vapor of ammonia often acts equally 
well, and is almost always to be found in every 
house. The vapor of camphor is also excellent. 
Put a teaspoonful of the spirits of camphor into a 



DISEASES OF CHILDREN. 339 

teacup of hot water and inhale the vapor as it rises, 
snuffing it well up the head. 

Another. — Into a wide mouthed bottle capable 
of holding an ounce, mix two drams each of car- 
bolic acid and spirits of hartshorn ; then put in 
cotton batting enough to absorb the mixture, and 
inhale the vapor, keeping it corked when not in 
use. The evolution of the vapor may be increased 
by setting the bottle in a cup of hot water during 
inhalation. 

When the severity of the disease is spent on the 
chest, the following will relieve the inflammation 
and soreness, promote expectoration and overcome 
the cough : 

Tincture of Aconite, ... 10 drops. 

Tincture of Bloodroot, - - - 1 dram. 

Paregoric, - - - - - 3 dram. 

Compound Syrup Squills, - - 12 drams. 

Mix. Dose — For a child two to nve years old 10 to 15 drops 
three or four times a day. For an adult a teaspoonful. 

If there is a sense of dryness in the throat and 
bronchial tubes, a whistling noise in breathing, a 
poultice of flaxseed applied warm as can be borne 
will aid its relief. 

If there is much prostration less aconite is to be 
used, and more quinine, and if necessary, alcoholic 
stimulants, in slings, milk punch, wine, brandy, etc. 

Great care must be taken not to catch a fresh 
cold during the course of the disease, which is apt 
to continue a week or two, unless the treatment 



340 PAINLESS CHILDBIRTH, 

cuts it short, as it would be very apt to bring on a 
renewal ot the attack more severe that at first and 
perhaps cause a serious disease of the lungs. 

After the severity of the attack is passed, tonics 
may be required, as iron, quinine, syrup of hypo- 
phosphites, etc. 

CROUP. 

The causes of this alarming malady are princi- 
pally cold and damp. The disease is most prevalent 
in the fall and winter months, and a child having 
been once attacked, will be extremely liable to its 
return on slight exposure, particularly when the 
weather is cold, damp or changeable. 

For convenience we will divide it into catarrhal 
or mucous, spasmodic, and membraneous or true croup 

Symptoms. — The catarrhal or mucous variety is 
the most prevalent, and usually comes on suddenly 
during the night, although there may have been 
symptoms of a cold for a day or two previously, 
with some cough and hoarseness, but not sufficiently 
severe to occasion any anxiety. 

The child is wakened suddenly from a sound 
sleep with difficulty of breathing, and a peculiar 
brassy cough, which once heard can never be for- 
gotten ; the head is thrown backward, the eyes 
protrude, the countenance expresses anxiety, the 
breathing attended with a whistling sound, the 
voice is rough and hoarse, croaking, and is finally 
reduced to a whisper. Sometimes the child is dis- 
posed to be drowsy, waking as the paroxj'sms occur. 



DISEASES OF CHILDREN. 341 

The accumulating mucus in the throat causes 
choking and rattling. At first the skin is hot and 
dry, the pulse hard and full, but unless the child is 
relieved the pulse gets weak, the face livid, the 
extremeties cold and the skin bathed in a cold per- 
spiration. 

These attacks almost invariably occur at night, 
and while an attack lasts from two to fourteen days 
unless controlled by the treatment, there will be an 
improvement during the day, to be followed by an 
exacerbation again at night, usually at about the 
same hour. 

After the croupy symptoms have disappeared, 
a catarrhal cough will be likely to remain for sev- 
eral days. 

. In the spasmodic form there may be some little 
evidence of a cold in the evening, but the child 
will be comparatively well when put to bed ; in two 
to four hours it will get restless, and finally be sud- 
denly wakened with fright and suffocation, strug- 
gling for breath, with the peculiar metallic cough ; 
the pulse, however, will be regular and the skin 
natural and moist. This paroxysm soon subsides 
to recur again after a short interval. These attacks 
are disposed to grow lighter, and finally disappear 
leaving a cough that lasts a day or two 

This form when uncomplicated seldom termin- 
ates fatally, and its disposition to recovery has 
favored the establishment of a reputation for many 



342 PAINLESS CHILDBIRTH. 

remedies that in the other varieties of the disease 
are of very doubtful value. 

Cases are sometimes met in which the mucus and 
spasmodic varieties are so blended that it is diffi- 
cult to decide to which form of the disease the case 
belongs. 

The membraneous variety, it should be remembered, 
though rare, is by far the most dangerous form of 
the disease, and it is very important that it be rec- 
ognized as early as possible, and prompt measures 
taken to avert its consequences. This form comes 
on gradually, usually being preceeded for several 
days by a cold. The cough is harsh and rough, 
with perhaps moderate soreness of the throat, but 
it gradually becomes metallic and brassy, and par- 
oxysms may occur at any time, day or night. There 
is more or less fever, the breathing dry and whis- 
tling, the hoarseness increases, the fits of coughing 
become more frequent, the paroxysms more severe, 
and the voice subsides to a whisper. 

All the symptoms increase as the disease ad- 
vances, and if not relieved, the constriction of the 
larynx becomes constant, the lips blue, the Veins 
distended, the extremeties get cold and the child 
sinks into a stupor that terminates in death. 

The false membrane may be seen if the throat is 
examined, and pieces are sometimes detached, by 
coughing, of a grayish color, tough and tenacious, 
that in fatal cases closes the air passages and cause 
death by suffocation. There will not be the moist 



DISEASES OF CHILDREN. 343 

rattling sound in this form of the disease that is 
heard in the mucus variety, but a piece of mem- 
brane may become loosened and flap back and 
forth wjth each inspiration and expiration. There 
are not the periods of relief in this form that are 
present in the others, but progressing it may ter* 
minate fatally in from six to sixty hours. 

Treatment. — The application, to the throat, of 
cloths wrung out of hot water will often give relief. 
Some physicians advise cold water but I confess I 
never tried it. Goose oil or lard, applied to the 
chest, and given internally in teaspoonful doses are 
popular in some parts of the country, but I have 
no confidence in them. Woolen cloths wrung out 
of an infusion of hops, or hops and vinegar, and 
applied to the chest as hot as can be borne, are 
beneficial, and the inhalation of the hot steam from 
the same infusion is valuable. In the application 
of such means care should be exercised to prevent 
the cloths becoming cold and doing more harm 
than good. 

In the spasmodic form of the disease five drops 
each of the tincture of aconite and belladonna, dis- 
solved in half a goblet of water, and administered 
in teaspoonful doses every fifteen or twenty minutes 
is a valuable remedy. The homeopathic or specific 
tinctures are preferred. As the disease yields, and 
the paroxysms become less frequent and severe, the 
intervals between the doses should be lengthened. 

In severe cases the aconite and belladonna mav 



344 PAINLESS CHILDBIRTH. 

be alternated with tartar emetic half a grain in 
half a goblet of water and a teaspoonful given 
every half hour or hour. It is a powerful depres- 
sant and should be used cautiously, and its use dis- 
continued when nausea or prostration is noticed. 
In this form of the disease relief should be obtained 
before the ill effects are observed. 

In catarrhal croup, aconite is one of our most val- 
uable remedies. It controls the fever and inflam- 
mation, and aids in preventing exudation taking 
place in the throat. Five drops in half a goblet of 
water should be given in teaspoonful doses every 
fifteen minutes. The addition of a quarter of a grain 
of tartar emetic in the solution of aconite is a favorite 
form of administration with many physicians. 
Given in this way its ill effects are not likely to 
occur. 

When the catarrhal secretion is profuse, and the 
throat so full of mucus that it embarasses respira- 
tion seriously, an emetic becomes necessary. For 
this purpose many homeopathists rely on tartar 
emetic in larger doses than those mentioned, but I 
do not like it. The more prominent among the 
alopathic school, use the turpeth mineral, or yellow 
subsulphate of mercury. If given early, a no less 
authority than Prof. Fordyce Barker, of New York, 
claims it will certainly avert a fatal result. The 
dose is three to five grains, rubbed up with sugar 
and placed on the back of the tongue and swallowed. 
It gives rise to very little prostration, an advantage 



DISEASES OF CHILDBED. 345 

it possesses over other emetics, but this advantage 
is offset by the serious results that may occur from 
this dose, should vomiting not follow its adminis- 
tration promptly. I would therefore prefer to 
restrict its use to the membraneous form of the 
disease in which Prof. Barker has used it with ex- 
cellent success. . 

Physicians of the eclectic school rely on blood- 
root and lobelia as an emetic in this disease, and 
though nauseous, I regard them as less dangerous 
than those already described. The acetic syrup of 
bloodroot and lobelia when it can be obtained, is a 
remedy on which I place great reliance in croup. 
The following prescription can generally be ob- 
tained at any drug store, and answers the purpose 
well, if the real acetic syrup cannot be had : 

Tincture of Lobelia, ... 3 drams. 
Tincture of Bloodroot, - - - 3 drams. 
Simple Syrup, ... 1 ounce. 
Vinegar, 2% ounces. 

Dose — Fifteen drops to a teaspoonful repeated once in fifteen 
minutes till vomiting occurs. The dose must be varied accord- 
ing to the age of the child, the smaller dose generally being 
sufficient for those two or three years old. 

After vomiting give it in smaller doses an hour 
or two apart, continuing the aconite at the same 
time, and increase the intervals between the doses 
as the symptoms become less severe. If necessary 
it may be again pushed to cause vomiting in the 
same manner as before. Unpleasant as this medi- 



346 PAINLESS CniLDBIRTlL 

cine is, it is a very certain one, relaxing the spasm 
of the larynx, relieving the suffocation, removing 
the accumulations of mucus, and materially aiding 
in overcoming the inflammatory symptoms. 

In the membraneous variety the treatment must be 
prompt and effective. If the disease is recognized 
early and we can bring the pulse down to a natural 
frequency, we may be able to prevent the formation 
of the false membrane to any extent. 

Apply the hops and vinegar hot and repeat them 
often enough to keep up the heat. 

For the fever and inflammation give : 

Tincture of Aconite, 5 drops. 

Norwood's Tincture of Yeratum, - 10 drops. 
Water, - - - - - 4 ounces. 

Dose — A teaspoonf ul every twenty or thirty minutes, give it 
persistently till the pulse comes down to eighty or ninety per 
minute. If however prostration occurs and the pulse becomes 
feeble, with cold perspiration, it must be suspended entirely, or 
given at much longer intervals. 

Give the lobelia and bloodroot in does sufficient 
to cause nausea which should be continued till the 
membrane begins to loosen, then carry it to/vomit- 
ing, in hopes the effort will cause the membrane to 
be detached and expelled. 

If the suffocation is extreme we may resort to 
causing vomiting as soon as possible, as it will 
afford relief and give time to bring about the other 
effects of our remedies. 

When the child is in danger of immediate suffo- 



DISEASES OF CHILDREN 347 

cation, carry the finger back into the throat that 
the irritation it excites may cause immediate vom- 
ing, with the hope that some of the membrane will 
be detached and immediate relief afforded, and time 
gained for other measures. 

In giving the syrup endeavor to have it swallowed 
slowly, as its local as well as constitutional effect is 
desirable. 

Do not relax your efforts, nor be misled by a 
remission until the disease is well under control. 
Keep up the remedies until the membrane is entirely 
removed and convalescence is certain. Carry the 
remedies to vomiting whenever the spasm is severe 
and the suffocation is threatening. 

The treatment is unpleasant, but the character 
of the disease justifies the use of harsh measures 
until something better is discovered. 
PNEUMONIA. 

This affection, also known as inflammation of the 
lungs , lung fever , winter fever, etc., is an acute inflam- 
mation of the substance of the lungs, of frequent 
occurrence and serious in its results. Its fatality, 
however, has been materially diminished by the 
improved methods of practice of late years. 

When the disease is confined to a circumscribed 
portion of the lung it is termed lobular pneumonia ; 
when only one lung is affected, sinjle pneumonia ; 
when both lungs are involved, double pneumonia ; 
if pleurisy exists in connection, pleuro-pneumonia ; 



348 PAINLESS CHILDBIRTH. 

and when a typhoid condition is developed during 
its course, typho-pneumonia. 

In the majority of cases it is caused by cold, but 
those who have been debilitated by previous dis- 
eases, intemperance, faulty nutrition, etc., from any 
cause, are specially liable. 

Symptoms. — For a day or two there is languor, 
dullness, a feeling of oppression in the chest, short 
cough, chilliness, etc., similar to a common cold. 
These symptoms may not attract any attention for 
a day or two when the advent of the disease will be 
marked by a pretty distinct chill, often resembling 
that of malarial fever. In children the chill is 
often replaced by convulsions. This is succeeded 
by fever, pressure in the chest, which often increases 
to a constant pain that is aggravated by an annoying, 
and distressing cough. The pulse becomes frequent, 
the skin is hot and dry, the face flushed, the eyes 
red ; there is severe pain in the head and back, the 
appetite is lost, the tongue is covered with a whitish 
coat, the bowels constipated and the urine, scanty 
and highly colored, usually depositing a bran like 
sediment on cooling. As the disease advances res- 
piration becomes shorter and more difficult, the 
nostrils are dilated, and the chest and shoulders 
elevated with every effort at inspiration. Delirium 
is often present. 

At first the cough brings up a little frothy mucus 
that soon becomes opake, and about the fifth day it 
has become very sticky and tenacious, and assumed 



DISEASES OF CHILDREN. 349 

a peculiar rusty color, which is the characteristic 
expectoration of pneumonia. 

In mild or favorable cases and those in which 
the disease yields to the treatment properly, the 
expectoration now becomes more free, the cough 
looser and less painful, the fever diminishes, and 
the symptoms subside, so that in from seven to 
nine days from the attack convalescence is estab- 
lished. 

In the severer cases all these symptoms are in- 
creased. The delirium is constant, there is great 
prostration, picking at the bed clothes, and dirty 
accumulations are seen on the teeth. Expectoration 
may be profuse, purple, yellow or bloody, and the 
breathing greatly embarassed. In fatal cases the de- 
lirium passes into stupor and death may occur from 
the second to the fouth week. Eecovery, however, 
may take place by the gradual subsidence of the 
symptoms, but, a cough is apt to remain, or other dis 
eases of the lungs, as hepatization, hemorrhage, or 
consumption, develop. 

The diagnosis of inflammation of the lungs in 
children is not always easy until the disease is well 
advanced, although physicians by the aid of aus- 
cultation and percussion are abl e to distinguish it 
when the other symptoms are unreliable. To the 
unprofessional these aids are not available. Bron- 
chitis and pleurisy so much resemble pneumonia 
that it is often difficult to distinguish between them, 
but this is not so important to the general reader 



350 PAINLESS CIIILDBIMTIL 

for the treatment, particularly in the early stages, 
is almost the same. 

Treatment. — If we recognize the disease early 
and are successful in our efforts, we may cut it short 
or greatly modify its severity and thus materially 
promote recovery. Give a hot mustard foot bath 
at once, with warm teas internally to promote per- 
spiration, and then commence with the following : 

Tincture of Aconite, 5 drops. 

Fluid Extract Veratrum, - - 10 drops. 
Fluid Extract Asclepias Tuberosa, - 2 drams. 
Water, 4 ounces. 

MiXj and give a teaspoonful every hour till the skin shows a 
disposition to moisten and the pulse becomes less frequent, then 
lengthen the interval to two or three hours, and thus continue it 
till the inflammation is subdued. If, however, a typhoid condi- 
tion presents, with prostration and feeble pulse, the veratrum had 
better be omitted from the above prescription, on account of its 
depressing influence, if carried to far, or carelessly used. 

If the difficulty of breathing is marked and the 
pain in the side severe, as in pleurisy, I would give 
iii alternation to the foregoing : 

Tincture of Bryonia, ... 5 drops. 
Water, - - . - - - -4 ounces. 
Dose — A teaspoonful every hour till relieved, and then it may 
be omitted. 

A hot mush jacket or poultice applied to the 
chest throughout the disease is a measure on which I 
place great reliance. It should come well up to 
the top of the lungs in front, and extend well 
back under the arms, and should be renewed about 



DISEASES OF ORlLDBMtit. 351 

once in eight hours, or as often as it begins to smell 
sour. 

It is made thus : Cook corn meal well as mush, and 
spread from one-half to one inch thick between thin 
cloths or put it in a sack, and secure in place with 
pins, strings or bandages. It should be applied 
warm as can be borne, and covered with a dry- 
cloth, or oiled silk, but is not to be so thick and 
heavy as to cause fatigue. The meal may be cooked 
in water in which hops have been boiled, and the 
annodyne properties of the hops will aid the moist- 
ure and warmth in allaying the cough and pain. 

As soon as the pulse has been moderated by the 
aconite mixture and the skin is moist, give pretty 
full doses of quinine every four hours. The dose 
must depend upon the child's age, from one-half 
a grain for two years old, to two grains for a child 
of five or six years. Keep on with the aconite 
until the fever is controlled, gradually lengthening 
the intervals between the doses as the febrile symp- 
toms decline, until it is omitted entirely. 

If after a few days from the commencement of 
the disease the bowels are constipated as will often 
be the case, a mild cathartic should be given, and 
for this purpose I would give Husband's magnesia, in 
suitable doses proportioned to the age of the patient, 
or one-eighth of a grain of podophyllin, mixed 
with one-half a grain of leptandrin, triturated in 
sugar, and repeated once in twelve to twenty-four 
hours till a mild operation is induced. 



352 PAINLESS CHILDBIRTH*. 

The scantiness of the urine may necessitate a 
remedy, when three to five grains of acetate of 
potash in a tablespoonful of water, repeated three 
times a day, will act nicely. This dose may be in- 
creased if necessary, and for older children. 

Throughout the case give plenty to drink. Lem- 
onade, acid fruits, jellies, water, milk, etc., are most 
agreeable. 

The diet should never be solid, but very soft. 
Milk, beef tea, mutton broth, oyster soup, tea, soft 
toast, and if there is much prostration, milk punch, 
eggnog, wine, etc., but care should be taken never 
to over stimulate. 

A warm alkaline sponge bath, once or twice a 
day, will materially promote comfort and recovery. 
Warm water containing a little common soda or 
saleratus is all that is necessary, care being taken, 
however, to prevent exposing the body when bath- 
ing lest a chill occur. 

During convalescence, tonics are called for, iron, 
quinine, hypophosphites, etc. The following is a 
good combination : 

Quinine, - - - - - 10 grains. 
Compound Syrup Hypophosphites, - 2 ounces. 
Dose — For a child one to two years old, one-fourth to one- 
half a teaspoonf ul three times a day. 

Sleep is encouraged by bathing at bed time, but 
if necessary, small doses of Dover's powders at 
night may be given. One or two grain doses are 
sufficient. 



DISEASES OF CHILDREN. 353 

The cough is sometime very troublesome and 
may call for a special remedy, though in the milder 
cases the treatment already advised will be suffi- 
cient. When something of the kind is needed, and 
in those cases where the cough continues after the 
inflammation has subsided, give : 

Tincture of Bloodroot, - - - 1 dram. 

Tincture of Ipecac, - - - - 1 dram. 

Compound Syrup Squills, - - 1 ounce. 

Syrup of Wild Cherry, - - - 2 ounce. 
Dose — One-half to one teaspoonf ul three or four times a day. 
When the cough is unusually severe and annoying I add half an 
ounce of paregoric to the above ; some however, might prefer 
half a grain of morphine in place of the paregoric. This use 
of the opiate would of course overcome the necessity of the 
Dover's powder already memtioned. 

CHRONIC PNEUMONIA. 

Sometimes an attack of pneumonia will only 
partially subside and leave a chronic inflammation 
behind. In such cases more or less solidification of 
the lungs is likely to be present. Chronic inflam- 
mation of the lungs may also develop without the 
previous occurrence of an acute attack. 

Symptoms. — Respiration is shorter and quicker 
than natural, and attended with more or less diffi- 
culty. There is a harassing cough with a rusty or 
grayish colored expectoration, often coming up by 
the mouthful after a hard fit of coughing. There 
is languor, weakness, quick pulse, fever of an 
intermittent character, flushed cheeks, night sweats, 
impairment of nutrition, great wasting of flesh, 



354 PAINLESS CHILDBIRTH. 

and symptoms analogous to those of quick con- 
sumption. 

Treatments — The objects to be attained by- 
treatment are to arrest and subdue the inflamma- 
tion, improve nutrition, aid the recuperative powers 
of nature to rebuild the wasted tissues, and bring 
about absorption of the products of the inflamma- 
tion. The functions of the various vital organs 
must be looked after, and rendered as perfect as 
possible. Everything must be taken advantage of 
that can aid in building up and improving the 
powers of life. Let the diet be as nourishing as it 
is possible— milk, cream, eggs, beef, mutton, oysters, 
game, etc. 

A spoonful of good old whisky after each meal 
will aid digestion, and contribute to recovery ; the 
clothing should be warm, and a chest protector of 
several thicknesses of flannel quilted together worn 
over the chest; and the skin thoroughly rubbed 
each day. 

When there is great emaciation the rubbing of 
some animal oil into the skin daily, all it will 
absorb, is a good measure. I often order for this 
purpose half a teaspoonful of lard, with a grain or 
two of quinine, repeated daily. 

A blister or some other form of irritation applied 
over the affected lung will often be beneficial. 

As a tonic give : 

Fowler's Solution of Arsenic, - - 15 drops. 
Quinine, ~ - . - 15 grains. 

Compound Syrup Hypophosphites, - 4 ounces. 



DISEASES OF CHILDREN. 355 

D ose __ One-half to one teaspoonf ul, for children three to five 
years old, before meals three times a day. 

For the cough and to aid in absorption, particu- 
larly when some portions of the lungs are solidified : 

Fluid Extract Veratrum, - - 10 drops. 

Tincture of Bloodroot, • - - 2 drams. 

Muriate of Ammonia, - - - 1 dram. 

Syrup of Wild Cherry or Tolu, - 4 ounces. 

Dose — One-half to one teaspoonf ul three times a day between 
meals and at night. 

This is a serious disease and should not be tam- 
pered with. If the patient does not improve very- 
soon, a reliable physician should be consulted, for I 
sometimes find in such cases some complication 
that must be corrected, after which the usual treat- 
ment will succeed. 

CONSUMPTION. 

Consumption is a serious constitutional malady, 
characterized by a wasting of the body and at- 
tended by an affection of the lungs, in which 
sooner or later, tubercular deposits occur. No other 
disease is so widespread or fatal as consumption. 
It preys upon all classes of society, and is the cause 
of about one-seventh of all the deaths that occur 
in Europe and North America. 

It is much more prevalent among children than 
is usually supposed, and is closely allied to scrofula. 
Some writers regard them as essentially the same, 
one being only a modified form of the other. 



35G PAINLESS CHILDBIRTH* 

The disease is characterized by feeble vitality, 
emaciation, and loss of strength, sooner or later 
followed by a cough, expectoration, difficulty of 
breathing, fever, night sweats, hemorrhage, and 
death. 

The causes of this affection are two kinds: one 
prelisposes the system to the disease, and the other 
operating on a system thus prepared excites the 
disease into activity. 

Of the first kind we may mention hereditary 
predisposition, incompatibility of temperaments, 
and sexual diseases of parents, climate, depressing 
influences, and anything that lowers the standard 
of vitality. 

The second class of causes are coids, catarrh, 
syphillis, masturbation, spermatorrhoea, diseases of 
women, dyspepsia, measles, whooping cough, diph- 
theria, inflammation of the lungs, depressing emo- 
tions, a fast life, excessive sexual indulgences, 
exhaustive discharges, etc. Catarrh, colds, lung 
diseases, etc., play an important part. 

While some of these causes do not apply to 
childhood, I have introduced them here as a warn- 
ing to the older ones into whose hands this book 
may chance to fall. Impairing the constitutions 
of the parents, they are, through hereditary trans- 
mission, indirect causes of consumption. 

In spite of the fearful mortality of this disease, 
and the general belief that it is incurable, researches 
during the past twenty-five years prove conclusively 



DISEASES OF CHILDREN. - 357 

that it can be cured. All modern writers are agreed 
upon this point. Numerous cases are on record 
where complete recoveries have been made, and 
many years afterward the person has died from 
other diseases. Post mortem examinations have 
revealed many cases of the kind. 

The symptoms of consumption vary with the 
stage and progress of the disease. In most cases a 
general breaking down of the general health occurs 
for a longer or shorter time before the lung symp- 
toms are developed. Whenever we find a growing 
weakness, paleness, loss of flesh, quickened pulse, 
and shortness of breath coming on, without any 
apparent cause, we have just reason for anxiety 
These are premonitory symptoms, and remedies 
will now be found most efficient. Soon a cough, 
generally hacking, and worse at night, occurs. The 
patient says " I have taken cold and w T ill soon be 
all right/' Food does him no good ; the cough be- 
comes worse, expectoration more profuse. There 
may be a remission of all these symptoms, and the 
victim think he is getting well, but another cold 
sets him back, and develops the disease more severe 
than before, and fever and night sweats occur. 
Thus the disease goes on, alternating better and 
worse. Each time more severe, and the recovery 
not quite so perfect. This may last for years, or it 
may complete its course in a few months. It is 
needless to trace the disease further ; it is easily 
recognizable now, and its onward progress is 



So8 PAINLESS CmLDBIRm. 

marked with symptoms so plain that none need be 
longer deceived, 

In children, however, the symptoms of the lung 
disease are not always as well marked as in the 
adult, the deposition of that peculiar substance 
termed tubercle is apt to be more generally distrib- 
uted throughout the abdominal and thoracic viscera. 
Consumptive children may waste away and die 
without the development of the lung symptoms 
when it receives the more technical name of tuber- 
colosis. 

Treatment, — The most important consideration 
is the successful treatment, and the more thoroughly 
and persistently it is carried out, the greater the 
chances of success. Any who have the slightest 
reason to believe that they are developing a con- 
sumption, or are in the least danger of doing so, 
should not rest until they have marked out a course 
o c hygienic and medical treatment. Do not wait a 
single day, time is precious. Your life depends on 
what you do now. Do not be put off by evasive 
answers. If you have not implicit confidence in 
your family physician's skill, consult some one else. 
Do not permit deference to old fogyism to rob you 
of life. Errors committed now w T ill be overcome 
only with the greatest difficulty. 

We may indicate the general plan of treatment, 
but each individual is apt to present characteristics 
or modifications that will demand attention and 
perhaps require changes of remedies. It is too 



DISEASES OF CHILBBElf. 359 

serious a disease to admit of unprofessional control, 
and yet there is time to select competent profes- 
sional advice. I shall therefore beg the reader's 
pardon if I confine my remarks mainly to the out- 
lines of treatment, or to that part of it which the 
patients themselves, or their friends, must conduct 
for them. 

Take advantage if possible, of climate, hygiene 
and medicine. As to climate, seek if possible, that 
which will enable you to live a greater portion of 
the time in the open air. A dry clear air with an 
even temperature is best. Study the rules of hy- 
giene and do everything that can contribute to 
health. Take plenty of good air, exercise, nutritious 
food, and keep every organ in as nearly a healthy 
condition as possible. We must avoid every debil- 
itating influence. The disease breaks down. We 
must build up. The indications for treatment are 
plain, if we stop to think. There is a torpid liver, 
impaired digestion, insufficient nutrition, and the 
body wastes faster than it is nourished. A fever, a 
serious cough, a deposition of tubercular matter in 
the lungs and other tissues, ulceration and inflam- 
mation of the lungs, often serious hemorrhage, 
exhausting expectoration and sweats, irritation of 
the nervous system, and a gradual decay of the 
whole body with a marked diminution of the vital 
forces. These are the principal pathological condi- 
tions, and to meet them properly we mast regulate 
functional activity, improve nutrition and appetite, 



860 PAINLESS gbilbbihtil 

allay nervous excitement, fever and inflammation ; 
promote digestion, soothe the cough and prevent 
hemorrhage, relieve the circulation, diminish waste 
and heal the lungs. 

It is folly to depend upon cough medicines, for 
as a rule they only relieve one symptom at the 
expense of another; many of them ease the cough 
and destroy digestion. When employed they must 
only be expected to benefit the one symptom — 
cough. It must be understood that the cough in 
consumption is only a symptom of the disease, it is 
one of its branches as it were. 

The following prescription is a good one, partic- 
ularly in the early stages and should be used 
persistently : 

Fluid Extract Veratrum, - . 5 drops. 

Fluid Extract Lycopus Virginica, - 30 drops. 

Fowler's Solution, - - 8 drops. 

Water, 4 ounces. 

Dose — A teaspoonful every three or four hours. Adults 
should increase the dose proportionately. 

This may be alternated with any tonic remedy 
desired or suited to the needs of the patient 

If the liver manifests torpidity, I would give 
one-twentieth of a grain of podophyllin well 
triturated in sugar of milk and repeated every 
night. 

Details of this character should be presided over 
by a competent physician who will provide for 
such indications as they arise. 



MSBASES OP CElLmEtf. set 

The diet must be as nutritious as is consistent 
with digestion and assimilation. Every depressing 
influence should be avoided. 

The clothing must be warm and adapted to fur- 
nish protection against atmospheric vicissitudes. 

The discussion of the "Germ Theory" of disease 
has revived the employment of sulphurous acid gas 
by inhalation in consumption, it being claimed 
that this gas is one of the most efficient bacillicides. 
I am satisfied from experiments made by myself 
that it is beneficial to some extent, but I am yet in 
doubt about its being all-sufficient. The patient 
may inhale the vapor of sulphur evaporated on a 
warm stove or iron, several times a day, or spend a 
portion of his time in a room in which the gas is 
being liberated. It is apt to cause irritation of the 
throat and lungs at first, but after a couple of weeks 
the cough improves and the other symptoms sub- 
side. If the vapor becomes too dense at any time 
it causes suffocation. It is injurious to the cloth- 
ing. 

For several years I have employed in consump- 
tion, bronchitis and catarrh, a preparation in which 
sulphurous acid gas is a prominent character, and 
in some cases I have witnessed remarkable results. 
The difficulty attending its use, however, has pre- 
vented me from its general use, as many could not, 
or did not, manage it properly, unless they had re- 
ceived personal instructions from me. From what 
I have seen of it I would not expect any perman- 



362 PAINLESS CHILDBIRTH. 

ent benefit from it in consumption except ill the 
earlier stages. 

ASTHMA. 

This disease, also called phthisic, is a spasmodic 
affection of the lungs which comes on in paroxysms, 
generally at night, and is attended by difficult res- 
piration, tightness across the chest, a wheezing 
noise, inability to lie down, etc. These symptoms 
continue for several hours at a time, and terminate 
in the health of the patient, and without necessitat- 
ing any morbid changes in the structure of the 
lungs. Long continued, however, it may after 
repeated-attacks develop pulmonary disease. 

Asthma is essentially a nervous disease, and while 
not usually seen before puberty I have met with 
several cases among small children. When once 
developed it is apt to reappear at irregular inter- 
vals during the lifetime of the patient 

The symptoms are too familiar to require any 
description. 

The causes are obscure and varied. That which 
brings on an attack in one subject may have no in- 
fluence whatever on another. Atmospheric vicis- 
situdes, inhalation of dust, certain odors, etc., and 
nasal catarrh is a frequent exciting cause. Some 
persons will be entirely free from it while in certain 
localities and be attacked again as soon as they 
depart. I knew one man, who would be entirely 
free from the disease while he remained at home 
in Saratoga Springs, but if he went, even ten miles 



DISEASES OE CRILBnEtf. 863 

from home, would be sure to have an attack, arid 
if during the attack he returned home, when 
within a mile or two of home would experience 
perfect relief. 

The treatment is empirical. Eemedies without 
number have been advocated to be tried and dis- 
carded. Change of climate is often serviceable, 
but no climate will furnish immunity for all, or 
even a majority. The climate which one asthmatic 
finds beneficial will be of no advantage to another. 

During the late war I knew several soldiers who 
were entirely free from it while in Virginia, but the 
disease returned on coming home. 

If I had an asthmatic child I would seriously 
consider a change of climate for its benefit, and 
would expect to have to go a long distance to get 
the greatest benefit by the removal. 

Chronic bronchitis and nasal catarrh, co-existing 
with asthma will be likely to defeat any plan of 
treatment that does not consider their cure. I have 
seen the asthma yield readily after these complica- 
tions had been overcome. Any plan of treatment 
should include the correction of all co-existing 
diseases. 

Temporary relief may almost always be afforded 
by inhaling the fumes from burning nitre, and 
strammonium, or belladonna leaves. Mix one- 
fourth pound of coarse powdered strammonium 
leaves and one pound of nitre, burn a tablespoon- 
ful of the mixture and inhale the smoke ; repeat if 



S64 Painless citildbifitr. 

necessary. This may be varied by using half stram- 
monium and half belladonna leaves to the same 
proportion of nitre. Blotting paper soaked in a 
strong solution of nitre, dried and burned is also 
effective. These substances furnish the basis for 
all the cigarettes, smokes, pastiles, etc., now in use. 
The California plant grindelia, combined with 
other remedies to suit the peculiarities or complica- 
tions of the different cases, has proved beneficial in 
many instances. The following will usually afford 
temporary relief : 

Tincture of Bloodroot, - - 3€ ounce. 

Tincture of Lobelia, - - - K ounce. 

Bromide of Potash, - - - ^2 ounce. 

Simple Elixir to make 4 ounces. 
Mix. Dose — For an adult, a teaspoonf u.l every half hour or 
hour till relieved or nausea is produced. Smaller doses for child- 
ren. This is an excellent though nauseous remedy. Some find 
pretty large doses of quinine capable of cutting short an attack. 

Attention to the bowels is necessary. A cathartic 
dose of podophyllin, or a compound podophyllin 
pill, taken at the commencement will often modify 
an attack. 

Measures for a permanent cure, if undertaken, 
must be persevered with for a considerable length 
of time, and are to be continued daring the inter- 
vals as w 7 ell as during an attack. 

WHO OPING COUGH. 

This is a disease peculiar to childhood but is 
sometimes witnessed in adults. It prevails as an 
epidemic, uninfluenced in its occurrence by season; 



DISEASES OF ClTlLDliEN. SG5 

rarely attacking an individual more than once, which 
is generally the first time they are. exposed to its 
causative influence, though cases are known where 
it has reappeared a second and even a third time. 

It is due to a specific poison, which appears to be 
communicated directly from one child to another, 
yet it is presumed that some peculiar atmospheric 
condition is favorable to its propagation, and is the 
principal means by which it is spread. Be this as 
it may there is plenty of evidence for and against 
this theory, but as no good can well result to the 
non-professional reader from its discussion, it will 
be omitted. 

It generally runs a regular course lasting from 
six to ten weeks, and were it not for the complica- 
tions liable to develop during its course, would 
seldom or never prove fatal. Spasmodic cough, 
bronchitis, etc., often continue for a long time after 
the specific disease has run its course. 

Whooping cough is essentially a nervous disease, 
usually milder in warm than in cold climates, and 
is less severe when it occurs during warm weather. 

Symptoms, — The disease may be divided into 
three stages ; the catarrhal, the spasmodic, and the 
terviinal 

The first is very similar to an ordinary cold, ac- 
companied by slight fever, languor, loss of appetite 
and restlessness, with more or less cough. Some- 
times these symptoms are severe, and in other cases 
pass unnoticed. 



SGG PAINLESS CHILDBIRTH. 

After two or throe weeks the fever abates, and 
the cough which has gradually developed becomes 
peculiar, persistent, spasmodic, and characterized 
by a loud shrill inspiration or whoop which gives 
the disease its name. The cough comes on in par- 
oxysms, varying in frequency from once or twice a 
day to as many times in an hour. When a fit of 
coughing comes on the child instinctively grasps 
something for support, or runs to its mother for pro- 
tection, but returns to its play when the paroxysm 
is ended. During the paroxysm which may last 
from a few seconds to several minutes, there is a 
rapid succession of short, spasmodic coughs, suc- 
ceeded by the prolonged inspiration or whoop, 
during which the face becomes red, turgid and 
bloated, the blood vessels distended and the eyes 
prominent. The paroxysm often terminates in 
vomiting or the expulsion of a thick tenacious 
mucus. 

This vomiting may oe so serious as to materially 
interfere with nutrition, by causing the child to 
vomit so soon after eating as to prevent the diges- 
tion and assimilation of its food. 

This stage — the spasmodic — lasts from three to 
eight weeks, when it gradually subsides, terminat- 
ing in recovery unless some serious complication 
has been developed. 

In the first stage the expectoration is a frothy 
mucus. In the second it is transparent, yellowish, ' 
possibly purulent, ropy and tenacious. In the 



DISEASES OF CHILDREN. 36? 

third it becomes less tenacious, slightly opake, di- 
minishes in quantity and disappears. 

Sometimes this expectoration is so ropy it cannot 
be drawn out of the child's mouth with the fingers. 
When it is so very tenacious, and in feeble children, 
they may be aided by grasping it with the corner 
of a napkin and drawing it from the mouth and 
air passages. 

Treatment. — It is questionable if treatment 
ever does more in whooping cough, than to palliate 
and modify the symptoms and prevent or control 
complications. Unless it is prevailing in the neigh- 
borhood as an epidemic, it will be impossible to dis- 
tinguish the first stage from other catarrhal 
affections. When suspected give : 

Tincture of Aconite, ... 5 drops. 
Tincture of Belladonna, - - 5 drops. 
Water, -....- 4 ounces. 

Dose — A teaspoonful every hour or two. If the cough is 
harrassing add to the foregoing prescription half a dram of the 
tincture of drosera and give in the same way as before. 

A strong tea or infiusion of chestnut leaves, 
sweetened to the taste, and given in doses of one or 
two tablespoonfuls, five or six times a day, some- 
times exerts a wonderful control over the disease, 
in the first and second stages. The earlier it is 
given the better. If the leaves cannot be obtained, 
the fluid extract which can be got at nearly all 
drug stores, may be given in five or ten drop doses 
in water and repeated as often as the infusion. 



368 PAINLESS CHILDBIRTH* 

A tea of led clover blossoms has long been favor- 
ably known in rural districts, and may be given 
freely, sweetened or not.. Sometimes it will cause 
looseness of the bow T els. I have seen it control 
other forms of spasmodic cough very promptly. 

Acting upon the theory of the miasmatic origin 
of the disease, quinine has been given, and it is 
claimed, with remarkable benefit. Two to ten 
grains are given at.a dose, for*children from two to 
eight years old, respectively, and repeated four times 
in twenty-four hours. The dose is intended to be 
large enough to produce a decided effect. If it is to 
prove beneficial the first dose or two should be fol- 
lowed. by improvement. 

Fluid Extract of Belladonna, - 5 drops. 

Fluid Extract of Lobelia, - - 30 drops. 

Water, 4 ounces. 

Griven in teaspoonful doses every hour or two, to children 
under live years, will often afford decided relief from the spas- 
modic efforts. If taken too freely it causes vomiting and is 
therefore objectionable to some. 

Some of our homeopathic friends recommend 
msphilis in pretty strong terms, both in this disease 
and in asthma, but I can not speak of it from per- 
sonal experience. 

The following is an old fashioned remedy that 
often answers well when others fail : 

Cochineal, 10 grains. 

Bicarbonate of Potass, - - 1 dram. 

Fluid Extract of Belladonna, - 10 drops. 

Syrup, - .4 ounces. 

Dose — A teaspoonful three or four times a day. 



DISEASES OF CHILDREN. 3G9 

It has been my experience that remedies that re- 
lieve very effectually some years have very little 
influence in others. I do not pretend to explain 
this observation. 

I have found the following very efficient during 
two epidemics occurring in the fall and winter : 

Bromide of Potash, 2 drams. 

Fluid Extract of Veratrum, - 10 drops. 
Fluid Extract of Black Cohosh, - 1 dram. 

Syrup, - - - - - - 4 ounces. 

Mix, and give a teaspoonful four times a day. It speedily 
modifies the spasms, controls the bronchitis, an*d relieves all the 
symptoms. Belladonna in equal proportion may be substituted 
for the veratrum if relief is not obtained in two or three days. 
This may be given at the same time the infusion of chestnut 
leaves are employed ; giving the doses an hour or two apart. 

Two or three days is usually long enough to de- 
termine whether a remedy is goiug to do good or 
not, and if no improvement is apparent in that 
time, something else may be tried. 

Attention should be given the bowels, to keep 
them regular, also to any other unnatural conditions 
that may occur. 

If there is decided determination of blood to the 
head, the head hot, with dizziness, extreme suffoca- 
tion, the expectoration stringy and profuse, I would 
use the last named prescription with a good deal of 
confidence. 

MUMPS. 

This is an inflammation of the parotid g!anda ; 
situated just under the ear, hence the name parotitis, 



370 PAINLESS CHILDBIRTH. 

It is produced by a specific miasm, and usually 
occurs in childhood, and when both sides have 
been affected it rarely returns. We often see cases 
where only one side has been affected. In these 
cases, perhaps years afterwards, the individual may 
have another attack, which will be confined to the 
opposite side. It usually occurs as an epidemic, 
and appears in from five to twenty days after the 
exposure. Children under three years of age are 
rarely affected. 

Symptoms. — There is more or less febrile disturb- 
ance, chilliness, and sometimes vomiting, followed 
in from twelve to thirty-six hours by a pain under 
the corner of the jaw, sometimes extending into 
the ears. Soon after the advent of the pain a swell- 
ing begins, that sometimes attains an enormous 
size. This swelling generally reaches its greatest 
size on the fourth or fifth day, when it remains 
stationary for a day or two, and gradually declines, 
so that by the twelfth day it has entirely disap- 
peared. It may involve both sides simultaneously, 
or may appear on one side first, and about the time 
of its disappearance on this side, attack the other. 

An old fashioned domestic diagnostic symptom, 
that appears to be ignored by the profession, was to 
have the suspected individual eat a pickle or some 
acid substance, when if it caused severe twinges of 
pain, running into the swollen gland, it was pro- 
nounced mumps without any farther ado. 

A peculiarity of this disease is that the inflam- 



DISEASES OF CHILDREN. 371 

mation is liable to suddenly disappear from the 
neck and appear in the testicles of the male, or the 
breasts or ovaries of the female, more especially if 
the afflicted person " catches cold" during the prog- 
ress of the malady. Serious consequences, amount- 
ing to impotence or sterility, sometimes occur by 
this metastasis as it"is termed. 

Treatment. — We have no remedies that do 
more than modify the severity of the disease, and 
many persons, particularly when the attack is mild, 
do nothing at all farther than to remain in doors, 
and perhaps take a few extra precautions against 
taking cold. 

A mild laxative may be given if the bowels are 
sluggish, and if the febrile symptoms are severe, 
give : 

Tincture of Aconite, 10 drops. 

Water, 4 ounces. 

Dose — A teaspoonf ul every hour or two. If the swelling is 
severe, add to the aconite and water half a dram of the saturated 
tincture or fluid extract of poke root (Phytolacca decandra) and 
take it as before. At the same time apply hot fermentations to 
the neck. A poultice of common beans cooked till nearly done, 
bruised, and applied is excellent. 

Aconite is the remedy and if properly pushed, 
and proper care exercised to guard against cold, it 
is rare that suppuration or metastasis to other 
glands will occur. 

Should it disappear from the neck suddenly and 
attack those other parts mentioned, keep on with 



372 PAINLESS GHILDBIBTH. 

the aconite and phytolacca, and also give in alter- 
nation : 

Tincture Pulsatilla, 15 drops. 

Tincture Gelseminum, - - - 30 drops. 
Water, 4 ounces. 

Dose — A teaspoonf ul every two to four hours between the 
doses of the other. Apply to the swollen parts, as warm as it 
can be borne, a solution of muriate of ammonia in water, an 
ounce in a pint of water. 

Rest in the recumbent position under such cir- 
cumstances should always be enjoined, and the 
swollen parts carefully supported instead of being 
permitted to hang down. 

To secure rest and if the pain is severe, a dose of 
Dover's powder proportioned to the age of the 
patient should be given. 

When the gland suppurates it should be opened 
by the knife, and a poultice of elm, flaxseed, or 
bread and milk applied and frequently changed. 
This will be better than to endure the pain and 
suffering for many days, waiting for the forming 
abscess to break itself. 

SORE THROAT. 

This is a very common complaint and we meet 
with numerous cases that do not admit of the cus- 
tomary classifications, as they are neither diphthe- 
ria nor quinsy they are too often ignored. 

We might perhaps satisfy sticklers for names if 
we include all these cases under the one general 
classification — pharyngitis, but after all it is u sore 



DISEASES OF CHILDREN. 373 

throat." Sore throat is often an accompaniment 
of other disease?. 

There are several varieties of the affection, de- 
pending for the most part upon atmospheric condi- 
tions resulting in colds, as the exciting cause. The 
predisposing causes are catarrh of the head and 
throat, scrofula, impaired constitutional vigor, ven- 
ereal taint, and many person acquire a habit of 
having a sore throat on exposure to cold, damp, 
changeable weather, etc. Diphtheria, quinsy, laryn- 
gitis, etc, often leave behind them a tendency to 
sore throat. When a person has once suffered 
from a severe sore throat, future attacks are to be 
feared. 

Chronic sore throat is very prevalent. 

Symptoms. — The symptoms vary according to 
the cause, and peculiarities of the patient. The 
throat is tender, inflamed, and sometimes ulcer- 
ates. During an inflammatory attack there is chills 
and fevers, hoarseness, a desire to swallow often or 
clear the throat, the mucus membrane may be 
bathed in a profuse glairy mucus or it may be dry, 
irritable and husky. The natural color may be 
changed to an intense red, varying to a dusky or 
livid. The whole pharynx may be swollen, and if 
there is a tendency to ulceration the breath becomes 
exceedingly offensive, and examination reveals 
small ulcers which may run together and produce 
extensive sores. 

Usuallv these sore throats are more annoving 



374 PAINLESS CIIILBBIUTII. 

than dangerous in themselves, still if neglected 
when severe they may proceed to a fatal termina- 
tion. When neglected they are jipt to become 
chronic, and by extention downward along the 
mucous membrane into the lungs or stomach, are 
apt to give rise to serious consequence.?. 

The treatment must be varied to suit the con- 
ditions that present. If of the inflammatory 
variety, the throat red and swollen, pulse accelerated, 
and there are general febrile symptoms, aconite is 
pre-eminently the remedy, whether the patient is a 
child or an adult. It may be given in combination 
with belladonna. Put five drops of each in half a 
goblet of water and take a teaspoonful every hour. 

Then give chlorate of potash as a gargle, and 
permit a little of it to be swallowed every three 
hours. A teaspoonful of the crystals in half a 
goblet of water is about the proper strength. The 
compressed tablets of chlorate of potash which can 
be got at any drug store, are more convenient, as 
they can be carried in the vest pocket, and dis- 
solved in the mouth and swallowed slowly as they 
dissolve. The dose for children may be one-fourth 
to one-half a tablet, or two or three grains every 
two or three hours. 

If the breath is offensive give a grain or two of 
the second trituration of the red iodide of mercury, 
or pink powder, as it is often called. It comes the 
nearest to being a specific in the majority of cases 
of "sore throat" yet discovered, and is specially 



DISEASES OF CHILDREN. 375 

valuable when the breath is offensive, though if 
there is inflammation never omit the aconite. 

Those subject to an attack of sore throat with 
e/ery change of weather, should 'carry a vial of 
aconite pellets, and a box of tablets with them for 
use at once. 

These remedies are always appropriate even in 
those cases where the predisposing cause is catarrh, 
scrofula, or syphilis, but a complete course of treat- 
ment, to completely overcome these constitutional 
affections must be instituted in the interval, only 
depending on the remedies above named for the 
relief of acute symptoms 

Wet packs about the neck facilitate the cure, but 
of course are only to be used when the patient re- 
mains in doors. Frequent bathing the neck with 
cold water, or whisky and water, on the outside, is 
beneficial in overcoming the sore throat habit. 

In chronic sore throats there is generally an 
impaired condition of the general health, that 
demands aid for the reparative powers of nature, 
by appropriate remedies, as well as the employ- 
ment of medicines for the local symptoms. 

QUINSY. 

Quinsy, or tonsilitis is, as the name indicates, an 
acute inflammation of the tonsils, implicating the 
uvula, soft palate, and throat generalty. One or 
both tonsils may be affected at the same time. It 
sometimes terminates in suppuration, requiring to 



376 PAINLESS CHILDBIRTH. 

Be opened with the knife, or perhaps breaks and dis- 
charges the matter itself. 

The causes are cold, change of temperature, 
damp, wet feet and all the usual causes of colds. 
Scrofulous persons are most liable to it. 

Symptoms. — At first there is a soreness or stiff- 
ness of the throat, with heat, and often pain. There 
may be chills which will be succeeded by fever. 
The throat is dry, hot and swollen, and swallowing 
becomes difficult and every attempt is attended by 
excruciating pain. 

The uvula is enlarged and elongated, the end 
dropping down into the throat occasions a sensation 
as if some foreign substance was lodged in the 
throat, causing frequent attempts at swallowing 
and giving rise to much irritation. 

On examination one or both tonsils are seen to 
be swollen, the uvula elongated, and the whole 
throat unnaturally red and shiny. The pulse is 
rapid, the tongue furred, and the bowels usually 
constipated. The pain from the inflamed tonsils 
often extends into the ears. 

As the disease advances the difficulty in swallow- 
ing increases to such an extent sometimes, that on 
attempting to swallow fluids, they are expelled 
through the nose. The speech becomes indistinct, 
and the thirst is great. These symptoms all vary 
in t-e verity. 

The symptoms described may continue from five 
to twenty days, and may gradually subside, or they 



DISEASES OF CHILDREN. 377 

may terminate in suppuration of the affected tonsil. 
The formation of matter is indicated by a throb- 
bing pain, sometimes accompanied by a chill. This 
throbbing continues until the swollen gland is 
opened, or breaks itself and a free discharge of mat- 
ter takes place, when the swelling is suddenly 
reduced, and all the symptoms subside, and rapid 
recovery takes place. 

Sometimes during the disease the tonsils are 
covered with little ulcerated patches, and may be 
mistaken for diphtheria. Sloughing may take 
place particularly in those whose constitutions are 
previously much impaired. 

Both children and adults are subject to the dis- 
ease. 

Treatment. — One of the first remedies to be 
thought of is aconite, five drops in half a goblet of 
water and a teaspoonful given every hour. It may 
be combined with phytolacca with benefit, thus : 

Tincture Aconite, - - - 5 drops. 

Fluid Extract Phytolacca, - - 15 drops. 

Water, 4 ounces. 

Dose — A teaspoonful every hour or two. 

If this prescription is given at the outset it will 
be likely to cut short the disease. Alternate it 
with : 

Tincture of Hyoscyamus, - - 30 drops. 
Water, ... 4 ounces. 

Dose — A teaspoonful every two to four hours, between the 
doses of aconite. Larger doses for adults. 



378 PAINLESS CHILDBIRTH. 

I do not remember ever having seen hyoscyamus 
recommended in quinsy, but I have used it in a 
number of cases with most gratifying results. 

A cathartic is almost always demanded. A seid- 
litz powder, or a dose of salts may be given, or what 
is better, podophyllin and leptandrin, one tenth of a 
grain each for a child, one-half grain each for an 
adult, and repeat in twelve hours if needed ; let it 
be taken at night as a rule, the saline in the 
morning. 

If the pain is so severe as to prevent sleep a small 
dose of Dover's powder may be taken at bedtime. 

Hot poultices applied to the neck are beneficial, 
and inhaling the vapor from an infusion of hops 
and vinegar sometimes affords marked relief. 

Frequent attacks are liable to result in a perma- 
nent enlargement of the tonsils, and give so much 
annoyance that an operation for their removal be- 
comes necessary. Scrofulous children are particu- 
larly subject to this form of trouble. 

DIPHTHERIA. 

Diphtheria is an exceedingly grave malady in 
which we have a profound constitutional disturb- 
ance, accompanied by a severe affection of the 
throat, characterized by the development of patches 
of false membrane, developed more or less exten- 
sively on the mucous membranes of the throat and 
air passages. 

There is probably no disease in which there is 



DISEASES OF CHILDREN. 379 

greater diversity of opinions regarding its pathol- 
ogy, causation or treatment. Some consider it 
primarily a disease of the throat, from which the 
whole system becomes rapidly infected ; while 
others regard the local trouble as a consequence of 
the constitutional disease, instead of a cause. 

That there is a specific poison, the nature of 
which is yet unknown, there is no question. It is 
contagious and infectious, and often prevails as an 
epidemic, though isolated cases are seen, supposed 
to depend upon some local cause, as defective sew- 
age or drainage. 

Diphtheria is no respecter of person, age, condi- 
tion, rank or temperament. Whole families are 
sometimes destroyed, although children under ten 
years furnish the greater percentage of its victims. 

The symptoms vary in different cases, from a 
mild sore throat to the most serious and malignant 
blood poisoning. Between these extremes we meet 
with every grade of intensity. The exudation of 
" false membrane " is the most certain diagnostic 
sign. 

There may be premonitory symptoms, as languor, 
dullness, fretfulness, thirst and impaired appetite, 
but they are apt to pass unnoticed. These may last 
two or three days, when there will be chilliness 
sometimes amounting to a severe chill, succeeded 
with feverishness, headache, backache, and in some 
cases rheumatic pains, with derangement of the 
skin, kidneys and bowels. 



380 PAINLESS CHILDBIRTH. 

There may be a stiffness of the neck, heat and 
irritation in the throat at the outset, but usually 
the throat is not complained of until the fever is 
developed. On examining the throat it will be 
found somewhat swollen, of a red or livid hue, at 
first covered with a glairy mucus, soon to be fol- 
lowed by ashen gray spots on the membrane, which 
are usually grouped together in clusters, becoming 
more numerous as the disease advances, and, co- 
alescing, extend over large surfaces presenting the 
peculiar ashen gray wash-leather appearance char- 
acteristic of the disease. This peculiar exudation 
may take place upon the surface of any mucous 
membrane in the body. It frequently extends up- 
ward and lines the nasal cavity, and downward 
into the larynx and trachea, seriously endangering 
life by suffocation, or it may extend downward 
along the esophagus into the stomach and bowels, 
and has extended the whole length of the alimen- 
tary canal. 

There is more or less fever, usually typhoid in 
character. The pulse varies from rapid and full at 
first, to feeble ; or it may be slow and feeble at the 
outset. The temperature is frequently very high. 

The saliva is thick and tenacious and difficult of 
removal, the breath offensive, the teeth become 
covered with sordes, and the lips black and parched. 
After two or three days the exudation is liable to 
become detached, leaving the surfaces beneath raw 
and extremely sensitive, so that the attempts at 



DISEASES OF CHILDREN. 381 

swallowing or even breathing, are exceedingly pain- 
ful. The more extensive the patches of membrane 
are, the greater the difficulty of detaching them 
will be, and as one edge becomes loosened before 
the rest it may be heard to flap back and forth with 
each respiration, with a noise well calculated to oc- 
casion anxiety. The denuded surfaces may ulcerate, 
and foul, unhealthy sores replace the " false mem- 
brane." 

In mild cases, when the membrane has not yet 
been formed, it may be mistaken for catarrhal sore 
throat, but in all such cases, particularly if prevail- 
ing in the neighborhood, the great depression of 
the system is sufficient cause for alarm and sugges- 
tive of immediate action. 

In some cases an eruption has appeared upon 
the skin, so nearly resembling scarlet fever that 
many have been led to regard the two diseases as 
identical. 

Sometimes in the beginning of the severer forms 
of the disease the patient will be attacked with 
vomiting of a yellowish watery fluid ; this may be 
followed by a purging of a matter similar. in char- 
acter. After a painful restlessness the patient may 
sink into a stupor or unconsciousness, which may 
be again replaced with delirium, and all the powers 
of life rapidly fail. 

In fatal cases death may. occur from blood poi- 
soning, the patient gradually sinking, but moie 
often it is occasioned by the sudden formation of 



382 PAINLESS CHILDBIRTH. 

heart clots. Suffocation is also a frequent form of 
death, when there will usually be a gradual de- 
cline, the patient becoming unconscious and coma- 
tose before the end, owing to the accumulation of 
carbonic acid in the blood. 

When the disease terminates favorably a marked 
improvement in all the symptoms generally takes 
place from the fifth to the tenth day. The swelling 
of the throat subsides and the patches of false 
membrane cease to re-form as the different portions 
become loosened and are thrown off. The local 
discomfort gradually disappears and the general 
symptoms rapidly improve. The temperature per- 
manently becomes natural, the appetite returns, 
the skin and kidneys resume their natural func- 
tions, and with the exception of the muscular 
weakness, the invalid feels quite well. 

The danger, however, is not yet entirely over, for 
relapses frequently occur, with a new formation of 
false membrane and a return of the most serious 
symptoms ; or there may be a clot formed in the 
heart, with a sudden failure of its action, and 
death by fainting result ; and even when there is 
an escape from these contingencies, at a later pe- 
riod there may occur diphtheritic paralysis. Jt is 
well' therefore, that the convalescence be well 
guarded, and care taken against all ordinary exer- 
tion and exposure for some little time after the 
symptoms have disappeared. 

Treatment. — It is folly to advise that the man- 



DISEASES OF CHILDREN. 383 

agement of so grave a disease be undertaken with- 
out the attendance of a physician, and though such 
be the case, in view of the conflicting opinions, I 
will venture to describe such treatment as has 
served me best. 

If possible the patient should be put into a clean, 
dry, well aired bed, in a good sized, well ventilated 
room. The room should be one that can be kept 
at a moderate temperature. Exclude every one 
from the room not necessary for the care of the 
sick person, and thus prevent as much as possible 
the spread of the malady. Disinfectants should be 
employed about the room and are not only bene- 
ficial to the patient, but afford a certain degree of 
protection to the attendants. Chloride of lime may 
be used for the purpose, exposed in dishes and oc- 
casionally a little vinegar poured upon it. Under 
the direction of the physician a little sulphur may 
be burned in the room, care being taken that the 
sulphurous acid gas disengaged does not become so 
dense as to cause suffocation of the patient. 

We must maintain the vital powers by all the 
means at our command. Nutritious and stimulat- 
ing food is necessary from the commencement, 
beef tea, mutton tea, milk, eggs, wine whey, milk 
punch, etc. If milk disagrees the addition of a 
little lime water will usually overcome the objec- 
tion. Repeat or alternate these articles so that 
every two or three hours some nourishment is 
given. 



384 PAINLESS CHILDBIRTH. 

To control the fever, neutralize and eliminate the 
poison from the system, I have long had confidence 
in veratrum, and I believe if it is given sufficiently 
earl} 7 and so employed as to keep the pulse at about 
seventy-five or eighty beats to the minute, or a 
trifle higher, depending on the natural pulse beat 
incident to the patient's age, that no exudation in 
the throat will occur, or at leasf prove trifling. I 
am not unaware, that such an opinion may meet 
with ridicule from those who have not witnessed 
this action of the remedy, but my confidence in the 
remedy is the result of clinical experience. 

I would put fifteen drops of the green tincture or 
ten drops of the fluid extract in four ounces of 
water, and give it in teaspoonful doses every half 
hour or hour, till the skin becomes moist and the 
pulse comes down to nearly a natural frequency, or 
nausea ensues. When either of these conditions 
are attained, suspend the veratrum a few hours till 
the fever rises again, and then repeat it ; or, 
what is perhaps a better plan, as these conditions 
are produced, give the doses at longer intervals, 
from two to four hours. For older persons give 
doses in proportion to age. An adult may take 
from one to three drops at a dose with the same 
object in view. 

The depressing effect of the veratrum is to be 
watched, and if it occurs will be manifested by 
nausea, profuse cold perspiration, and rapid falling 
of the pulse, even below seventy beats to the mill- 



DISEASES OF CHILDREN. 385 

ute I have never seen any of these ill effects from 
its use when blood poisoning of this character was 
present, and I have given it freely, but when it has 
been given under other circumstances I have seen 
common doses manifest alarming consequences. 

Alternate the veratrum with one or two grain 
doses of the second decimal trituration ( ^\ to ^V °f 
a grain) of the red iodide oj mercury (the pink 
powder mentioned elsewhere) every three or four 
hours. Let it be dropped into the throat and dis- 
solved. 

As an antiseptic and tonic the use of quinine has 
many advocates and should be given in one to 
three grain doses repeated in from four to six hours, 
adults larger doses. Many physicians combine it 
with the tincture of chloride of iron, thus : 

Quinine, 3^ dram. 

Tincture Chloride of Iron, - - 2 drams. 
Syrup, 2 ounces. 

Dose — A teaspoonful in a wine glass of water four to six 
times in twenty-four hours, for children four to six years old. 
To protect the teeth it may be sucked through a glass tube. If 
the quinine gives rise to deafness, or buzzing in the ears, it is to 
be suspended twelve to twenty-four hours and then resumed in 
smaller doses. 

A gargle of five drops of carbolic acid in an 
ounce of water used freely and frequently repeated 
is good practice ; if a little is swallowed it is not 
harmful. 

Blowing a few grains of powdered sulphur into 



38G PAINLESS CHILDBIRTH. 

the throat through a quill or tube, is highly recom- 
mended by many physicians. 

I have found an infusion of bayberry bark, into 
a pint of which two or three drams of the chlorate 
of potash has been dissolved, used freely as a 
gargle, very effective. It is not unpleasant and 
speedily heals the ulcerations. 

The employment of caustics and forcible removal 
of the exudation are things of the past, and only 
employed when speedy death from suffocation is 
threatened. 

The kidneys and bowels may need attention dur- 
ing the disease, though the use of the iron mixture 
will be likely to be all the kidneys will require, and 
if the bowels need opening a small dose of castor 
oil suffices. Active catharsis is not to be thought of. 

It is well to continue the iron and quinine 
though in smaller doses until convalescence is 
thoroughly established. 

The warm sponge bath repeated two or three 
times a day is beneficial and should be employed. 
Tepid water, or water containing a little carbolic 
acid, suffices for the bath. 

CEREBRO-SPINAL MENINGITIS. 

This exceedingly fatal disease is also called 
spotted fever. It is infectious, and usually occurs as 
an epidemic, prevailing as a rule in circumscribed 
localities, and does not seem to be retarded by the 
best sanitary regulations. The young and vigor- 



DISEASES OF CHILDREN. 387 

ous as well as the debilitated and infirm are among 
its victims. But little is known regarding its 
cause. 

Symptoms. — The symptoms vary according to 
the severity of the disease to such an extent that 
Stille has termed it the "chameleon-like disorder." 
The attack commences abruptly with lassitude and 
muscular pains, soon followed with a chill, intense 
headache, vomiting, dizziness, and great prostra- 
tion. There may be mental excitement amount- 
ing to delirium, but this gives way sooner or later 
to depression and a disposition to sleep, or uncon- 
sciousness. At first there is intolerance of light and 
sound, to be replaced later on, by insensbility to 
both. The greatest suffering is from the pain in 
the head and spine. A curious symptom is that 
when the patient is insensible, a slight pinch, or 
even the attempt to open the eyelids will call out 
an expression of pain. 

The muscles of the neck, back and extremeties 
become painful and rigid, the head drawn back- 
ward and the back curved so that the body de- 
scribes the arc of a circle. The face is pale and 
shrunken, the features pinched, indicative of great 
suffering. Muscular twitchings occur and in some 
cases general convulsions. The surface of the 
body is very sensitive to the touch and a slight 
motion sometimes will be sufficient to excite a 
spasm. 

Some little time mav be consumed with these 



388 PAINLESS CHILDBIRTH. 

symptoms so that the disease may not reach its 
height for three or four days, but in the severer 
forms of the malady, the patient is suddenly 
stricken down with a chill and dies in a few hours, 
without showing any signs of a reaction. In such 
cases the chill is speedily followed by a rapid sink- 
ing of all the vital powers, the skin becomes blue 
and cold, the blood settles in blotches under the 
skin in various parts of the body, perhaps oozes 
from the nose, gums, mouth and skin, and there is 
a short period of delirium followed hy a stupor 
from which the patient never revives. 

So rapidly may the disease do its work that the 
characteristic bending backward may not occur, and 
I have seen cases in which the blood spots did not 
appear till after death. 

In mild cases the muscular pains, headache, stiff- 
ness of the muscles, fever, etc., may. be present two 
or three days, and then gradually disappear with- 
out the development of the other symptoms. 

When recovery does take place there may be a 
long period of great nervous irritability, feebleness, 
together with more or less perversion of all the 
faculties. 

Fatal relapses sometimes take place after several 
weeks of apparently satisfactory convalescence. 

Treatment. — Great diversity of opinion pre- 
vails in regard to the proper treatment of cerebro- 
spinal meningitis, and no suggestions I may offer 
should be permitted to take the place of professional. 



DISEASES OF CHILDREN. 389 

attendance. The variable character of the attack 
necessitates the best judgment in the selection of 
remedies. In the severer cases all our efforts seem 
powerless. 

Many physicians regard opium in some form or 
other, either administered by the mouth, or what is 
preferred, hypodermic injections of morphine, push- 
ing the remedy to the extent of relieving the mus- 
cular rigidity, modifying pain, and preventing 
convulsions, as the remedy par excellence. 

The dose required to produce this effect is usually 
larger than would be necessary under other circum- 
stances. The remedy is generally regarded with 
favor by both American and European physicians, 
and it may be said that it relieves pain better than 
any other drug even if it accomplishes no other 
good. 

It is best adapted to those cases in which the 
force of the attack is manifested by inflammation 
of the brain and spinal membranes, but in those 
cases in which disintegration of the blood occurs 
so rapidly, we are compelled to employ stimulants 
mainly. 

The use of veratrum has been productive of suc- 
cess in some cases in which inflammatory action 
together with the symptoms of blood poisoning 
were combined, enormous doses have been given, 
and contrary to its supposed poisonous action, no 
bad effects were manifested until the severity of 
the disease had begun to yield, when the doses had 



390 PAINLESS CHILDBIRTH. 

to be lessened. In one case that came to my knowl- 
edge, a small child having been given up by sev- 
eral physicians was given enormous doses of 
veratrum, and made a speedy recovery. 

I must confess, however, that I should not want 
to resort to such hefoic medication, and in its em- 
ployment would carefully watch the approach of 
prostration, to guard its depressant action by stim- 
ulants, particularly at the time prostration occurred 
as a consequence of the disease. 

I would use veratrum thus : 

Fluid Extract of Veratrum, - 20 drops. 
Water, 4 ounces. 

Dose — For a child, three to five years old, a teaspoonful 
every two hours. 

With a view to its alterative and derivative 
influence I would give : 

Podophyllin, 1 grain. 

Cream of Tartar, - - - - 1 dram. 
Opium, 2 grains. 

Mix, and make eight doses, and give one to a child four or 
five years of age, every four hours until they produce pretty free 
watery evacuations from the bowels. Given in this way it will 
not be very likely to gripe nor disturb the stomach. 

The application of heat to the back of the neck 
and spine is a measure recommended by good 
authorities, and may be managed by cloths wrung 
out of hot water, or hot bottles of water. This 
should be frequently repeated and often gives 
decided relief. It may be aided bythe free applica- 



DISEASES OF CHILDBEX. 391 

tion of the following liniment applied when the hot 
cloths are being changed : 

Tincture of Aconite Root, - - J£ ounce. 
Tincture of Opium, - % ounce. 

Tincture of Arnica, - * - - 1 ounce. 

Mix. 

Perspiration is to be encouraged before the ex- 
treme prostration has developed, and for this pur- 
pose ears of corn boiled and wrapped in cloths and 
applied around the paiient is an excellent way of 
applying moist warmth. 

Attention to the bladder should not be forgotten. 
This organ is often paralyzed and will need measures 
for its relief. Heat placed over the lower abdomen 
will sometimes succeed, but, if it fails, a catheter 
must be used. 

Prostration must be combatted by stimulants, 
among which ammonia, capsicum, and alcohol are 
at the head, together with moderate doses of quinine. 
But little can be said as to the dose. It must be 
governed by the effect, while they do good, retard 
the failure of the vital powers or improve symp- 
toms, they may be pushed, but many times they 
will produce but a transitory affect or no result 
at all. 

From the commencement a good nutritious diet 
must be given. Beef essence, animal broths, eggs, 
milk, milk punch, etc., should be given alternating 
so that some nourishment is administered as often 



392 PAINLESS CHILDBIRTH. 

as once in three hours. Stimulants, as already re- 
marked, are to be given cautiously. 

During convalescence, quinine and iron, are 
necessary and may be given for a considerate 
length of time. 

SMALL POX. 

Small pox, or variola, is an eruptive fever, prop- 
agated by a specific contagion, running a definite 
course, rarely attacking a person more than once, 
though cases are on record where it has attaked 
individuals, twice and even three times. It is 
caused by exposure to the effluvia arising from the 
small pox patient, during the pustular period, or 
from excrementitious matter thrown off during the 
disease. How long this matter retains its infectious 
character is unknown, but it is certain that it may 
be conveyed in the clothing, or otherwise a long 
time after these media have been exposed to the 
contagious material. 

Symptoms. — After exposure to the contagion, a 
period of incubation, varying from seven to eighteen 
or even twenty days — usually about twelve — 
elapses, before any special indications of the dis- 
ease appears. Then there is headache, lassitude, 
mental depression, and a severe chill, or perhaps 
several chills in succession. Fever develops with 
nausea and vomiting, intense pain in the back and 
legs, the headache becomes more severe, the mind 
confn-ed which may amount to delirium. The 



DISEASES OF CHILDREN. 393 

pulse is rapid, the tongue coated and the breath 
offensive, the throat sore and eyes bloodshot. In 
young children convulsions are apt to occur before 
the eruption comes out. The fever continues high 
until the eruption appears, which will be from the 
end of the second to the fifth day. 

The eruption, which is the diagnostic mark of the 
disease, first appears on the forehead and scalp, 
about the eyes and mouth, and then extends to the 
body and extremities. 

When the eruption is delayed till the fourth day 
and the pustules well separated from each other, the 
attack is likely to be mild and is called discrete 
small pox ; but when it appears early, and the 
eruption so close that the pustules run into each 
other it is apt to be severe, and is then termed con- 
fluent small pox. 

The eruption first appears as small red pimples, 
which gradually becomes more prominent. These 
pimples are at first hard, but disappear for a 
moment under pressure. About the third day, 
and sometimes as early as the second, there appears 
upon the top of these pimples, a small vesicle con- 
taining a transparent fluid, in the center of which 
there will soon appear' a small depression or pit. 
They attain their size about the eighth day after the 
attack, and the fluid in them then becomes opake 
and in two or three days they begin to dry down 
and form scabs. 

When the eruption has first appeared there is a 



394 PAINLESS CHILDBIRTH. 

diminution of the fever, the headache and pain in 
the back and limbs are relieved, but return again 
about the seventh or eighth day and continue for 
a longer or shorter period, dependent largely upon 
the severity of the case, and the amount of matter 
reabsorbed into the system ; the chills and fever be- 
ing due to the blood poisoning going on. 

About the tenth or eleventh day the swelling of 
the face subsides, and the hands and feet swell. 
There is now great itching, and the vesicles break 
and pour out a liquid matter that forms crusts 
that are the cause of the disfiguring pits. 

In the severer forms the return of the fever is 
accompanied with intense pain in the head and 
back, with delirium which may be so acute as to 
necessitate constant watching. Diarrhoea and in- 
testinal hemorrhage sometimes occur during this 
stage. 

In some cases the disease is so mild as to require 
little or no attention, while in others it is of the 
most malignant character, and the sufferer is re- 
duced to a mass of putrescency. Between these 
extremes may be seen all grades of intensity. 

Treatment. — Small pox has a regular course to 
run, and the object of treatment therefore, is to 
mitigate its severity and guide it to a successful 
termination. 

It is highly important to isolate the patient at 
once, and maintain a rigid quarantine to prevent 
the spread of the disease. 



DISEASES OF CHILDREN. 395 

Secure a commodious, well ventilated apartment 
where the atmosphere need not become loaded 
with the emanations from the patient, not too cold, 
nor yet too hot, and maintain as nearly an even 
temperature as possible, and let the room be well 
disinfected by carbolic acid or other disinfectants 
freely sprinkled about. 

Give the patient a warm sponge bath two or 
three times a day in which a small quantity of 
carbolic acid is dissolved. 

For two pr three days before the characteristic 
eruption appears it will be difficult to determine 
the disease unless it is prevailing in the vicinity, 
or the patient is aware of having been exposed to 
it. As soon, however, as it is known that the dis- 
ease is small pox give : 

Fluid Extract Veratrum, - - 10 drops. 
Fluid Hydrastis, - - - - 30 drops. 
Water, - - - - - 4 ounces. 

Mix, and to a child five years old give a teaspoonful every 
hour, lengthening the intervals as the fever subsides and increas- 
ing when the fever increases, and continue till the fever disap- 
pears. This will also control the stomach. 

The internal use of carbolic acid, is believed by 
some to be of value in diminishing the severity of 
the blood poisoning, and a drop in half a wine- 
glassful of water may be given three times a day. 

The saracenia, or pitcher plant has acquired some- 
thing of a reputation in this disease, and is tfelieved 
to materially lessen its severity. The influsion of 



396 PAINLESS CHILDBIRTH. 

the plant, an ounce steeped in a pint of water, and 
the whole taken in twenty four hours is regarded 
as the best mode of administration. 

Should the condition of the bowels require a lax- 
ative, a seidlitz powder, calcined magnesia, or some 
of the laxative mineral waters in appropriate doses 
may be given. 

Pain, irritation, and wakefulness may be so severe 
at times as to demand the use of opiates, when 
paregoric, or tincture of opium, or Dover's powder 
may be given in suitable doses to afford ease and 
sleep. 

To prevent pitting a great variety of plans have 
been tried, but the principle of them all is to ex- 
clude the air. The following is a good formula : 

Carbolic Acid, - - - - 4 1 dram. 
Fluid Hydrastis, - - - - 1 ounce. 
Glycerine, - 5 ounces. 

Mix, and apply with a soft brush or camel's hair pencil, care- 
fully avoiding breaking the pustules. Repeat the application 
several times a day as often as it partially dries. It will allay 
the troublesome itching and disposition to scratch. 

From the first a supporting diet must be given, 
beef tea, mutton broth, eggs, milk, oysters, etc.; and 
particularly is nourishment demanded at the time 
of the maturation of the pustules; at this period 
the use of milk punch, brandy, or whisky sling 
should be used to support the vital powers and 
favor the process of pustulation. If the eruption 
strikes in suddenly warm drinks should be given, 



DISEASES OF CHILDREN. 397 

and milk punch, or camphor sling, made by putting- 
three or four drops of the spirits of camphor into 
a cup of warm sweetened water, should be repeated 
every three or four hours. In the severer cases the 
eyes should be protected by darkening the room or 
covering them with a mask. 

Diarrhoea may occur and should be treated with 
small doses of the neutralizing mixture and per- 
haps two to ten drops of the fluid extract of cranes- 
bill, small doses of the tincture of cinchona, say 
five to ten drops for children, every two or three 
hours, is well adopted to the necessity. 

During convalescence, nourishment is usually of 
more consequence than medicine, except the hy- 
drastis in two or three drop doses, or the cinchona 
in five or ten drop doses, three times a day, increas- 
ing the dose in adult patients proportionately. 

CHICKEN POX. 

Chicken pox, or varicella is a mild eruptive dis- 
ease having some resemblance to small pox, but 
very much milder. An eruption appears — gener- 
ally much scattered, principally on the body — as 
small red pimples which soon develop into vesicles, 
and in some instances becomes pustules. 

It rarely appears in children over ten or twelve 
years old, is of short duration, seldom leaving any 
pit, and generally last three to six days. It almost 
invariably appears as an epidemic, and is supposed 



398 PAINLESS CHILDBIRTH. 

to depend upon some specific contagion, the sus- 
ceptibility to which is exhausted by one attack. 

There is seldom any fever .till the eruption 
appears, then the temperature raises somewhat, and 
there may be headache, thirst, constipation, irrita- 
tion of the eyes, severe itching, etc. 

But little or no treatmerit is necessary. If there 
is much fever a mild laxative of citrate of magne- 
sia, and a few drops of aconite in a glass of water, 
given in teaspoonful doses every hour or two is all 
that is necessary in the way of medicine. A warm 
bath, and precaution against taking cold should be 
employed. 

MEASLES. 

Measles, or rubeola, is a contagious eruptive fever, 
due to a specific poison, propagated by contact 
with the sick or some article of clothing, in which 
it may be carried long distances. 

Measles prevail epidemically, at any and all sea- 
sons, but most generally during cold weather, and 
is then most severe, attacking all ages, but princi- 
pally the young. It seldom attacks a person more 
than once, and is" apt to be more severe among 
adults than children. It is attended with a more 
or less serious inflammation of the mucous mem- 
brane of the respiratory organs, varying from a 
slight catarrh to a severe bronchitis or pneumonia. 

Symptoms. — A. period of incubation varying 
from seven to fourteen days — generally about ten 



DISEASES OF CHILDREN. 399 

da} T s — after the exposure, febrile symptoms ac- 
companied by catarrh make their appearance. The 
early symptoms may not differ materially from a 
common cold ; there are chills and fever, coughing 
and sneezing, discharge from the nose ; the eyes 
become inflamed, sensitive to the light, and 
watery ; there is headache, the throat feels raw, 
and there is hoarseness with thirst, disturbance of 
the appetite, etc. These symptoms vary greatly in 
intensity. 

Usually on the fourth day from the beginning of 
these symptoms, the characteristic eruption appears 
upon the face, in the edges of the hair and fore- 
head, whence it extends to the neck, breast, 
body and extremities, reaching its maximum in 
thirty-six to fort} 7 -eight hours. The eruption then 
remains stationary two or three days when it grad- 
ually disappears, in about the order of its appear- 
ance, and by the eight or ninth day is all gone. 

This characteristic eruption appears as small dull 
or dingy red, slightly elevated circular spots, 
resembling flea bites ; at first separate with intervals 
of naturally colored skin between them, but soon 
run together in such a manner as to form crescent 
shaped patches,. slightly elevated above the surface 
of the skin. 

The symptoms described are sometimes varied, 
and the eruption may appear out of its regular 
order. A person may wake in the morning after a 
restless night covered with the eruption, without 



400 PAINLESS CHILDBIRTH. 

having noticed the early symptoms ; or the " break- 
ing out" may be delayed beyond the fourth day 

The only disease measles are likely to be con- 
founded with is scarlet fever, but there are 
distinguishing features, The eruption of measles 
is darker than that of scarlet fever, and gives the 
skin greater roughness ; it being at first separate, 
then forming the crescent shaped blotches, while 
the eruption of scarlet fever is usually in patches 
of a bright red color. 

In measles the eruption appears later than in 
scarlet fever. In measles it is first seen on the face 
and forehead, in scarlet fever on the neck and 
chest. In measles the catarrhal symptoms are 
characteristic except in very mild cases, but are 
rarely present in scarlet fever though the throat is 
sore. These characteristics, though varying some- 
what in different cases, will generally enable the 
reader to make a correct diagnosis. 

During the development of the eruption the 
fever is generally pretty high, and there may be 
delirium, but when the measles are well out, it sub- 
sides, unless the bronchial irritation is so severe as 
to cause its renewal. When the eruption declines 
naturally, yellowish decolorations remain and the 
skin is thrown off in fine scales. 

Sometimes the eruption is slow in coming out, 
or suddenly receeds after it has made its appear- 
ance, when the fever is likely to be greatly aggra- 
vated, and the bronchial irritation becomes a 



DISEASES OF CHILDREN. 401 

serious and troublesome complication. This often 
develops into pneumonia, which is liable to leave 
behind a pulmonary disease that may terminate in 
consumption. Ordinarily measles are not a severe 
disease. Some years they are extremely mild, 
while in others the mortality is great. 

When the eruption is very dark, and the powers 
of life greatly depressed, malignancy being the 
type of the disease, it is often termed black measles. 

Treatment. — In mild cases very little medicine- 
is required, a hot foot bath, a warm sponge bath, 
and warm drinks, with extra precations against 
taking cold, may be all that will be needed. Care 
must be taken to prevent taking cold for some time 
after the disappearance of the eruption. If the 
fever is excessive, aconite is the remedy, and may 
be given alone or in connection with the pleurisey 
root or asclepias, thus : 

Tincture Aconite Root, - - 10 drops. 
Fluid Extract Asclepias, - - 2 drams. 
Water, 4 ounces. 

Dose — A teaspoonful every hour or two. This will not only 
modify the fever and induce moderate perspiration, but will 
materially aid in bringing out the eruption. 

When the eruption is tardy in making its ap- 
pearance I would add five drops of tincture of 
belladonna to the above prescription and give in 
the same wav. 



402 PAINLESS GHILDBI11TH. 

The cough may require a remedy, then give : 

Tincture Ipecac, 15 drops. 

Tincture Drosera, - - - - 30 drops. 
Water, - ... 4 ounces. 

Mix, and give a teaspoonful every two hours, continuing the 
aconite. 

Should the bowels be constipated an injection is 
preferable to physic ; or if medicine is to be used, 
a mild dose of castor oil, or calcined magnesia may 
be given, but I prefer not to use cathartics while 
the eruption is out, as it favors its sudden " strik- 
ing in," 

Secure rest at night by a warm bath, and if nec- 
essary a dose of Dover's powder, adapted to the 
patient's age. 

When the irritation of the lungs is great, and 
does not yield to the foregoing, as will sometimes 
be the case, and a true bronchitis or pneumonia 
developing, the chest should be enveloped in warm 
fermentations, or the mush jacket as advised for 
pneumonia, be employed. Then give : 

Fluid Extract Lobelia, - - % dram. 

Fluid Extract Asclepias, - - 2 drams. 

Morphine, % grain. 

Syrup of Squills, .... 4 ounces. 

Dose — One-fourth to one teaspoonful every two to four hours, 
sufficient to afford relief, the dose to be varied according to age. 

Throughout the disease the diet should be nu- 
tritious. Give broths, soups, milk, milk punch, tea, 
toast, etc. 



DISEASES OF CHILDREN. 403 

When all the symptoms are disappearing and 
the condition of the lungs does not require any- 
special remedies, I give tincture of pulsatilla ten 
drops in half a glass of water, in teaspoonful doses, 
every two or three hours. 

When there is great malignancy, supporting 
treatment is demanded, and milk punch, whisky 
toddy, beef tea, eggnog, etc., are called for, and 
quinine should be given in from one to five grain 
doses every four hours according to the age of the 
patient. The eyes often need protection, and may 
be lightly bandaged or the patient be kept in a 
darkened room. 

SCARLET FEVER. 

Scarlet fever, scarlatina, or "canker rash," as^it is 
variously called, is essentially a disease of child- 
hood and rarely attacks a person but once. It is 
an infectious and contagious eruptive fever, charac- 
terized by a scarlet colored eruption on the skin, 
associated with an inflammation of the throat. It 
is]communicated by contact, or inhaling the exha- 
lations of a person affected with it, and may be 
conveyed in the clothing for long distances. 

Physicians recognize three varieties of the dis- 
ease, distinguished by its severity : the simple, the 
anginose, and the malignant. Scarlet fever in any 
form is to be dreaded, for it is a treacherous malady ; 
an attack slight at first may become severe as it 
progresses, and te in in ate fatally, and mild cases are 



404 PAINLESS CHILDBIRTH. 

often followed after convalescence is established by 
a fatal disease of the kidneys; on the other hand 
cases that are severe at the outset, become milder 
as they progresses and terminate in complete 
recovery. 

Symptoms. — After exposure to the contagion 
four to several days intervene when the attack 
beging w T ith chills, more or less severe, languor, 
headache, fever, nausea and vomiting. Convul- 
sions frequently replace the chills in young child- 
ren. The throat is sore the tonsils swollen and 
inflamed. In twenty-four to forty-eight hours from 
the beginning the characteristic' eruption of the 
disease makes its appearance upon the neck and 
upper part of the chest from whence it extends 
over the rest of the body. In severe cases the 
eruption is delayed. 

The eruption consists of numerous little points 
or spots, of a bright scarlet color, which diffuse 
themselves uniformly over the skin, or appear in 
large irregular patches. The vivid color of the 
skin disappears under pressure, but quickly returns 
when the pressure is removed. 

At first the tongue is covered by a light yellow- 
ish coating through which numerous elevated points 
may be seen, about the fourth day this coating falls 
off leaving the surface of the tongue raw, and the 
elevated points swollen, giving it something the 
appearance of a large strawberry, from which we 
have " the strawberry tongue " of scarlet fever. 



DISEASES OF CHILDREN. 405 

About the fifth day from the beginning of the 
attack the eruption begins to decline, and in a day 
or two — remaining longer in severe than in mild 
cases — it has entirely disappeared. The eruption 
is often attended by a troublesome itching ; as it 
recedes desquamation of the skin commences, first 
falling off in a minute scurf, and later in large 
scales. 

In the mild or simple variety the symptoms are 
mild, and the trouble of the throat is not severe, 
the eruption comes out early and is of a pale rose 
color, and soon fades. 

In the anginose form all the symptoms are aggra- 
vated, the swelling of the throat is severe, and 
swallowing very difficult. On examination of the 
throat, the tonsils are seen swollen, dark red, and 
the mucous membrane presents more or less ulcer- 
ation ; the breath is offensive, and there is an acrid 
discharge from the nose, and the glands of the 
neck are inflamed, often forming abscesses. The 
eruption is more general, and the whole body pre- 
sents the appearance of a li boiled lobster/' 

The occurrence of the eruption gives no relief, 
but all the symptoms are apt to be aggravated. In 
this form the eruption does not follow the regular 
course, it does not come out so early and may soon 
recede; it often shows a tendency to recede and 
reappear, and the throat is likely to remain sore 
for sometime. 



406 PAINLESS CHILDBIRTH. 

In the malignant Jorm we have all the severity of 
the anginose variety from the first, and a state of 
prostration soon develops that rapidly assumes all 
the characters of typhoid. The pulse is small, 
irregular, indistinct, soft and so rapid as scarcely to 
be counted. The eyes are a dull red, with intoler- 
ance of the light, the cheeks flushed and dusky, 
and there is deafness, and delirium or stupor. The 
eruption is very dark colored, comes out late and 
disappears again in a few hours 

The tongue, teeth, and lips are covered with 
dark incrustations, the breath is exceedingly fetid, 
the breathing is rattling and laborious ; swallow- 
ing exceedingly painful and difficult, sometimes 
the whole neck becomes a dark livid color, the 
throat sloughs, and an offensive diarrhoea occurs. 
These symptoms are very likely to terminate in 
death on the second, third or fourth day. This 
form of the disease even under its most favorable 
circumstances, is extremely fatal. 

Severe kidney complications may occur in any 
form of the disease and attention to the secretion 
of the urine should never be overlooked, as entire 
suppression sometimes takes places. Relapses are 
of common occurrence and diseases of the lungs, 
eyes, ears, diarrhoea, dropsy, etc., often remain as 
sequellse of scarlatina. 

Treatment. — In the milder forms of the dis- 
ease the objects of treatment are to modify the 
fever, and promote the appearance of the eruption. 



DISEASES OF CHILDREN. 407 

A well ventilated room in which an even tempera- 
ture can be maintained, is highly desirable, Then 
a tepid sponge bath repeated two or three times a 
day will materially aid in promoting the comfort 
of the patient. This bath may be rendered more 
efficacious, by making it alkaline by adding a table- 
spoonful of saleratus or baking soda, to each quart 
of water. Then give internally : 

Tincture of Aconite Root, - - 10 drops. 
Tincture of Belladonna, - - 5 drops. 
Water, ... 4 ounces. 

Dose — A teaspoonful every hour or two, as the fever is severe 
or mild. 

Warm drinks, mint teas, warm lemonade, or hot 
whisky sling, in moderation, are useful in bringing 
out the eruption. 

Jf the throat is sore enough to demand anything, 
put tw r o drams. of chlorate of potash in a goblet of 
water and gargle the throat every two or three 
hours, at the same time swallowing a teaspoonful 
of the solution. 

In the anginose form make use of the bath, and 
warm drinks and give internally : 

Fluid Extract of Veratrum, - - 10 drops. 
Fluid Extract of Baptesia, - - 30 drops. 
Water, 4 ounces. 

Dose — A teaspoonful every hour. 

Give two grain doses of the second trituration of 
the red iodide of mercury every three or four hours, 



403 PAINLESS CHILDBIRTH. 

and between the doses gargle the throat with the 
chlorate potash solution, or in its stead gargle with 
the following : 

Powdered Cayenne Pepper, - 1 teaspoonful. 

Salt, 2 tablespoonfuls. 

Cider Vinegar, ... 4 ounces. 
Boiling water to make a pint. 
Infuse and strain, and use freely. 

The pungency of this mixture will make it 
objectionable to small children, but its use is apt to 
be followed by speedy relief Children too small to 
use a gargle may have the throat mopped out with 
a soft brush or sponge, but rough usu xge is not to 
be permitted. 

If the bowels require unloading an injection of 
tepid water is preferable to medicine. 

The tincture of chloride of iron 'is a useful rem- 
edy in this form of the disease, supporting the vital 
powers, neutralizing the poison in the blood, and 
promoting the action of the kidneys. The dos-3 
varies from five to twenty drops according to age. 
The following is an agreeable formula : 

Tincture Chloride of Iron, - -4 drams. 
Simple Syrnp, - 3 ounces. 

Dose — One-half to two teaspoonf uls in a wine-glass of water, 
every four hours. As each teaspoonful contains ten drops it is 
'easy to calculate the dose according to age. 

Tf the child is old enough this may be taken 
through a glass tube to prevent contact with the 
teeth. 



DISEASES OF CHILDREN. 409 

A stimulating liniment applied to the neck on a 

layer of flannel is serviceable, and the following 

answers well : 

Hemlock Oil, - - - - % ounce. 

Olive Oil, % ounce. 

Spirits of Hartshorn, - - - % ounce. 

Spirits of Camphor, - - - % ounce. 
Mix. 

Anointing the entire body three or four times a 
day with vaseline does much good, allaying the 
troublesome itching and promoting the comfort of 
the patient A ham or bacon rind is equally good 
if not better, though not quite so nice or fashionable. 

If there be great prostration, add a dram of 
quinine to the Iron mixture already mentioned, 
and give as before. Stimulants may also be re- 
quired, when milk punch, eggnog, wine whey, etc., 
are the most desirable forms. If they quiet and 
strengthen, they do good, but if they cause delir- 
ium they do harm, and should be suspended. 

If there is great nervousness, give a few doses of: 

Tincture of Gelseminum, - - 60 drops. 

Water, - - -- . ■ - - 4 ounces. 

Dose — A teaspoonf ul every two or three hours, timing its ad- 
ministration so as not to interfere with other remedies that are 
being given at stated intervals. 

If the functions of the kidneys fail and the urine 
becomes scanty, and thickens on being heated give: 

Acetate of Potash, ... 2 drams. 
Tincture of Apis, - - - - 15 drops. 

Water, - 4 ounces. 

Dose — A teaspoonf ul every four hours in plenty of water. 



410 1 'AINLE8S CHILDBIRTH. 

Care must be taken to determine that instead of 
there being no urine secreted, the bladder be not 
overfull, having lost its power of evacuation. When 
this is the case the bladder can generally be felt 
distending the lower abdomen. A hot sitz bath 
may afford relief, or a hot fermentation of hops on 
which a little spirits of camphor is sprinkled may 
be applied over the bladder. If these fail, instru- 
mental measures will be necessary. The bedding 
of children too young to tell may be found wet, and 
yet the bladder be distended with urine, that which 
dribbles away being in excess of the capacity of the 
bladder. Distinction must be made between sup- 
pression, or failure of the kidneys, and retention, or 
failure of the bladder to expel its contents. 

In the malignant form of the disease treatment is 
very uncertain and unsatisfactory, yet every effort 
must be made, stimulants are to be given perse ver- 
ingly, brandy, milk, beef tea, egg*, etc. The iron 
and quinine already advised should be given, and 
the bathing kept up, substituting a little cayenne 
for the soda. Then give internally : 

Tincture Rhus Tox., - - - 5 drops. 
Tincture Belladonna, ... 8 drops. 
Fluid Extract Baptisia, - - - 1 dram. 
Water, - - - - - 4 ounces. 

Mix. Dose — A teaspoon!" ul every two hours. 

Throughout the disease a nutritious diet should 
be -given, and alternated so that every few hours 
some easily digested nourishment is given, as beef 



DISEASES OF CHILDREN. 411 

tea, mutton broth, eggs, milk punch, wine, soft 
toast, etc., etc. 

Disinfectants should be exposed in the room, as 
chloride of lime, sulphurous acid gas, carbonic acid 
gas, carbolic acid, etc., as has been advised in diph- 
theria, small pox, etc 

Dropsical complications may occur after the sub- 
sidence of the other symptoms, usually about the 
twenty-first day, and seems most liable to follow 
those cases that have been mild. When it occurs 
put ten drops of apis and thirty drops of apocynum 
canabinum in a goblet half full of water, and give 
a teaspoonful every four hours, and alternate with 
ten drops of Fowler's solution in a like quantity of 
water, given in teaspoonful doses between the doses 
of the other. 

The alcoholic vapor bath may also be used at the 
same time with a view to remove the dropsical 
effusion through the skin by perspiration. 

During convalescence in the severer cases tonics 
are needed and the elixir of calisaya and iron in 
appropriate doses suits the requirements well. 

It is perhaps needless to add that a physician be 
called at the outset who can watch the develop- 
ments of the case and take advantage of conditions 
as they arise. I have detailed the treatment more 
particularly for the benefit of those who cannot 
have medical aid without delay, and as a guide in 
his absence, and not by any means to supercede 
him. 

ERYSIPELAS. 

This affection is a peculiar form of inflammation 



412 PAINLESS CHILDBIRTH. 

of the skin, and tissues immediately beneath it, with 
a disposition to extend itself over large surfaces, 
and accompanied by more or less severe febrile dis- 
turbance. When it arises spontaneously it is 
termed idiopathic erysipelas ; but when it attacks 
wounds it is called traumatic erysipelas. It is gen- 
erally considered contagious, and sometimes occurs 
as an epidemic, though isolated cases of the simple 
form is often met. The traumatic form is often 
epidemic in hospitals. 

Symptoms. — In isolated cases of the simple or 
superficial variety there may not be very general 
disturbance, the disease being localized on the skin. 
The skin inflames and is attended by an intense 
itching or burning sensation, with redness, which 
so gradually merges into the surrounding tissues 
that it is almost or quite impossible to tell where it 
begins or ends. This simple form scarcely merits a 
description except to illustrate an extreme of the 
disease. 

In the severer forms in addition to the symptoms 
mentioned, there is a chill at the outset, though it 
may be slight, soon followed with fever, loss of 
appetite, headache, nausea and perhaps vomiting, 
and there may be stupor or delirium when it 
attacks the face or head. A sensation of intense 
heat is felt in the skin where the disease sho.ws 
itself, stinging and itching, and attended with a 
swelling or puffiness, with a vivid redness which 
in a little while assumes a purple hue. The swol- 



DISEASES OF CHILDREN. 413 

Jen skin presents a glistening appearance and is 
very sensitive. 

Erysipelas frequently attacks the face and head 
though no part of the body is exempt. When it 
occurs in loose tissues like the eyelids, the swelling 
is much greater than in tightly drawn tissues, but 
the latter are most painful. The swelling of the 
face is often extreme ; the eyes may be closed and 
great deformity exist. Sometimes small blisters or 
vesicles appear on the affected surface. When the 
deeper structures are affected abscesses form, and 
typhoid symptoms are developed. The inflamma- 
tion generally reaches its height in two or three 
days, and in a day or two longer gradually declines 
and the skin assumes a yellowish hue and peels off. 

It often happens that when the inflammation has 
arrived at its greatest height at the point of its 
commencement, it will spread to adjacent tissues be- 
fore it declines, and in other instances advance in 
one direction as it declines in another, while at 
other times it leaves one point to attack another 
entirely remote. When situated on the head and face 
there is always danger of inflammation of the brain. 

Its ordinary duration is from seven to. fourteen 
days, but it may assume an erratic form and wander 
about, receding in one direction and spreading in 
another, keeping up its maximum severity. 

Treatment. — In the milder cases give : 

Veratrum, 10 drops. 

Water, .... - 4 ounces. 






414 PAINLESS CHILDBIRTH. 

Mix. Dose — A teaspoonf ul every hour or two, and apply the 
same frequently to the affected surface. I have often arrested 
it in isolated cases by applying the fluid extract of veratrum to 
the affected surface. 

It is well to give children five drops of the tinct- 
ure of chloride of iron in a wineglassful of water 
three times a day, however mild the case may bo. 

In the severer cases the veratrum should be used 
more energetically to subdue the fever, and if there 
is great redness of the skin, headache, and delir- 
ium, combine the veratrum with belladonna thus : 

Fluid Extract of Veratrum, - 15 drops. 
Tincture of Belladonna, - - 5 drops. 

Water, 4 ounces. 

Dose — A teaspoonf ul every hour or two. 

In the vesicular form of the disease, alternate 
the last named prescription with : 

Tincture of Rhus Tox., - - - 5 drops. 
Fowler's Solution, - . - - - 5 drops. 

Water, 4 ounces. 

Dose — Give a teaspoonf ul every two to four hours. 

The use of iron, as already described, alone or 
associated with quinine is a very popular remedy 
with many physicians, particularly when the dis- 
ease attacks persons previously debilitated. When 
constipation is present a laxative may be necessary, 
and a seidlitz powder, Rochelle salts, calcined mag- 
nesia, or even castor oil may be given. The diet 
must be nutritious and sustaining, animal broths, 
toasts, tea, milk, etc , and if the prostration is great 



DISEASES OF CHILDREN. 415 

stimulants may be necessary. The use of the tepid 
sponge bath will always allay fever and add to the 
patient's comfort. Let the hygiene be as thorough 
as possible. During recovery iron and calisaya 
makes an agreeable tonic. 

DIARRHCEA. 

Diarrhoea is an affection characterized by an in- 
creased frequency of the discharges from the bowels, 
of variable quantity and consistence, associated 
with derangement of the digestive function, but 
usually unattended with fever, inflammation, or 
hemorrhage. It prevails largely among children, 
at all seasons, but principally in the summer 
months. It often occurs as a symptom of other 
diseases and is one of the consequences of general 
blood poisoning. It is due largely to irritation of 
the intestinal tract from overloading the stomach, 
eating unripe, indigestible or irritating food, the 
presence of worms, imperfect digestion, biliary dis- 
turbances, want of tone in the bowels, teething, 
etc.; and in young children it is often caused by 
improper articles of food when the child first com- 
mences to eat, impure milk, etc. 

Symptoms. — The symptoms of diarrhoea vary 
considerably. There are frequent evacuations of 
the bowels of a more fluid character than is nat- 
ural. The discharges are generally preceded by a 
rumbling noise, uneasiness in the lower part of the 
abdomen, with a sense of weight or pressing down, 



4LG PAINLESS CHILDBIRTH. 

which is relieved as soon as the evacuation is com- 
pleted, but returns before the succeeding one occurs. 
In some cases the griping is severe, while in others 
it may be wholly absent. The tongue is usually 
coated, there is a bad taste in the mouth, and often 
nausea and vomiting. If the disease continues 
long, the strength is reduced, emaciation occurs, 
all the various functions are disturbed and the skin 
becomes dry and sallow. The appearance of the 
stools varies greatly. 

In diarrhoea arising from irritation of the bowels, 
due to acrid, indigestible food, green vegetables, 
over-feeding, the presence of worms, or from cold, 
etc., there are frequent, copious, offensive discharges, 
preceded by griping, flatulence, nausea with coated 
tongue, loss of appetite, headache, and if it con- 
tinues any length of time, prostration. When indi- 
gestible food is the cause, particles of the food may 
be seen in the evacuation. If due to worms, these 
paracites whole or in pieces may be seen, but the 
reader is referred to that subject for a more com- 
plete description. When from teething, there will in 
addition to the other symptoms be irritation of the 
nervous system, swelling of the gums, and the 
symptoms generally accompanying teething. 

When the disease is due to lack of tone in the in- 
testines, the relaxed vessels pour the watery portion 
of the blood into the intestinal canal where it is 
mixed with the other matters, thus causing copious 
watery stools, in addition to the other symptoms. 



DISEASES OF CHILDREN. 417 

The prostration in this form is rapid. When diar- 
rhoea is caused by an excessive secretion of bile, the 
passages will at first be mixed with greenish yellow 
matter, semi-solid and offensive, which as the dis- 
ease advances becomes more watery. The mixture 
of the vitiated bile with the acids of the stomach 
when present in much quantity in the intestines, 
occasions severe griping and offensive green dis- 
charges, mixed with mucus. The griping does not 
wholly cease after the evacuation, and there is ten- 
derness in the right side and, pit of the stomach. 
The mouth tastes bitter, the tongue has a dirty yel- 
lowish white coat, the appetite is lost, the skin is 
dry, and the urine scanty and high colored. The 
presence of bile in the stools can generally be rec- 
ognized by its appearance and smell. These symp- 
toms may be so combined and varied that a given 
case will not admit of classification under any of 
the recognized forms of the disease, and the dis- 
charges may amount to merely a looseness, and 
may consist of mucus, or be watery, and present 
every shade of color, and odor. 

Diarrhoea is distinguished from dysentery by the 
absence of fever, inflammation, and hemorrhage, 
which are characteristic of dysentery. There is an 
affection known as acute intestinal catarrh which oc- 
cupies a position midway between the two diseases 
and may occasion some confusion. It will be con- 
sidered separately. 

Treatment. — When the diarrhoea is due to the 



418 PAINIJBSS CHILDBIRTH. 

presence of irritating materials in the intestinal 
canal, as unripe fruit, indigestible food, etc., or the 
excessive secretion of bile. It is a good plan to 
preface all treatment with a mild purgative, which 
aids the efforts of nature by the expulsion of the 
offending matter, and often puts an end to the 
whole trouble. For this purpose the following is a 
good prescription, and very nearly resembles the 
old fashioned neutralizing mixture. Take : 

Fluid Extract of Rhubarb, - 2 drams. 
Bi-carbonate of Soda, - - -2 drams. 
Essence of Peppermint, - - % dram. 
Brandy, - - - 4 drams. 

Simple Syrup, .... 4 drams. 
Water sufficient to make four ounces. 

The dose of this for children, from two to five years old, is a 
teaspoonful or a little less, repeated every two hours, until it ap- 
pears in the stools, or a bright yellow color is seen in them, when 
it is to be stopped. 

A small dose of castor oil is good but not as sat- 
isfactory as the foregoing. 

If either of the foregoing does not put a stop to 
the diarrhoea make use of the following mixture : 

Tincture of Camphor, ... 1 dram. 
Tincture of Opium, 1 dram. 

Tincture of Catechu, 1 dram. 

Tincture of Capsicum. - - - % dram. 
Essence of Peppermint, - - % dram. 
Brandy to make two ounces. 

Dose — Ten to thirty drops, according to the age of the child, 
repeated every two to four hour3 or oftener in violent cases. It 
should be given in warm sweetened water. 



DISEASES OF CHILDREN. 419 

With these two prescriptions the majority of diar- 
rhoeas may be controlled, varying the doses to suit 
the age of the patient and violence of the attacks. 

Diarrhoea in which the tongue is heavily coated, 
but which is not due to over-eating, etc., but in 
which there is griping, flatulence, rumbling noise 
in the bowels, with offensive semi-fluid stools, is 
generally controlled very readily by : 

Fluid Extract 01 Mandrake, - - 5 drops. 

Fluid Extract of Veratrum, - - 3 drops. 

Water, - 4 ounces. 
Dose — A teaspoonful every hour or two. 

Painless watery diarrhoea, will usually yield to 
five drops of the compound tincture of cinchona 
in a teaspoonful of water, repeated every hour or 
two. It is also beneficial in those cases in which 
there is a want of tone in the intestines. 

When it is due to the irritation of teething, if 
the gums are swollen, lancing them freely is advis- 
able. Then give : 

Fluid Extract of Gelserninurn, - 10 drops. 
Tincture of Aconite Root, - - 5 drops. 

Water, -4 ounces. 

Dose — A teaspoonful every hour or two, and alternate it 
with : 

Fluid Extract of Mandrake, - 5 drops. 

Water, 4 ounces. 

Dose — A teaspoonful every hour or two, between the doses of 
the former. 

Great care should be exercised in administering 



420 PAINLESS CHILDBIRTH. 

opiates and astringents to children in intestinal dis- 
orders, for, though potent for good when properly 
employed, they are equally productive of harm 
when mismanaged. 

During the disease attention must be paid to the 
diet, and only light and easily digested food should 
be allowed. Toast, rice, boiled milk, tea, etc., are 
among the best articles. The patient should at the 
same time be kept in the recumbent position as 
much as possible. 

DYSENTERY. 

This disease, also known as flux, bloody flux, colitis, 
etc., is an acute inflammatory affection of the lower 
bowel, attended with looseness.. It is usually con- 
fined to the lower portion of the large intestine, 
and is attended with severe straining, bearing 
down, fever, and bloody stools, symptoms that dis- 
tinguish it from diarrhoea. 

Dysentery frequently occurs as an epidemic and 
is then more severe and fatal, than when it occurs 
in isolated cases. It is met with oftenest during 
the autumnal months. When dysentery occurs as 
an epidemic it is supposed to be due to some pois- 
onous germs floating in the atmosphere. It is also 
caused by malaria, and when occurring in the fall 
may be due to cold and moisture following intense 
heat ; cold, improper diet, etc.; a cause of consid- 
erable importance, is the chilling of the surface of 
the body during the autumn, when cool nights fol- 



DISEASES OF CHILDREN. 421 

low hot days. A person retires with a covering suf- 
ficiently comfortable at the time, but wakes in the 
night with a sense of chilliness. This causes the 
blood to recede from the surface, and being driven 
upon the intestines, by repetition, predisposes to 
the development of dysentery, on the operation of 
some additional cause however slight. 

Symptoms. — It will frequently be observed 
that constipation has preceded the attack, but for a 
couple of days before the disease develops there is 
loss of appetite, languor, uneasiness or tenderness 
in the lower part of the abdomen, chilliness, nausea, 
etc.; soon there is an increased frequency of the 
evacuations, with griping, etc ; as inflammation 
develops in the lower bowel there is burning and 
pain in the rectum, the discharges become more 
frequent and less abundant ; there is a constant 
desire to go to stool, and great efforts are made to 
expel something, which only results in the ejection 
of small quantities of mucus which are apt to be 
streaked w r ith blood. As the discharges pass 
through the inflamed parts they occasion intense 
pain. 

These symptoms continue to increase, and the 
quantity of blood becomes greater. The evacua- 
tions vary in appearance, sometimes frothy, con- 
taining portions of fecal matter, mucus, and blood. 
Again they appear like the washings of meat ; 
sometimes they are wholly mucus, or perhaps pure 
blood. More or less fever attends these symp'oms 



422 PAINLESS CHILDBIRTH. 

with dry, coated tongue, thirst, great prostration, 
and in malarious sections there will be evidence of 
congestion of the liver and obstructed circulation. 
Dysentery has no regular duration and may 
yield in a few days or it may be protracted into 
weeks, as the disease progresses, ulceration of the 
parts affected is liable to occur, when pus will ap- 
pear in the discharges The appearance of brown 
chocolate colored discharges, great prostration, 
typhoid symptoms, etc., indicate great danger; but 
the reappearance of the fecal matter except when 
it is passed in hard lumps is generally a favorable 
omen, as a decline in the inflammation is likely to 
follow, even though the suffering and all the other 
symptoms may continue for two or three days 
longer before much improvement is noticed. 

Treatment. — To empty the bowels by the use 
of the rhubarb mixture advised for diarrhoea, be- 
fore the development of severe inflammatory symp- 
toms, is a judicious measure. Then put the patient 
upon : 

Tincture of Aconite Root, - - 10 drops. 

Fluid Extract of Gelsemium, - 10 drops. 

Water, 4 ounces. 

Dose — A teaspoonful repeated every two hours, unless the 
characteristics of gelsemium appear as double, or indistinct 
vision, dropping lids, etc., when the dose must be lessened or 
given at longer intervals. This will not be likely to occur ex- 
cept in very young children. For adults the dose must be mate- 
rially increased. Alternate the foregoing with : 

Corrosive Sublimate, - - - Vz grain. 

Fluid Extract of Ipecac, - - 1 dram. 

Water, - - - ... 8 ounces. 
Dose — A teaspoonful every two to four hours, according to 
the severity of the symptoms. 



DISEASES OF CHILDREN. 423 

These remedies have proved themselves so near 
specifics in my hands that I place great reliance 
upon them. 

If the pain and tenesmus are severe, I give a dose 
of paregoric or laudanum once in eight hours, 
until some degree of comfort is obtained. The 
dose should be proportioned to the age of the pa- 
tient, and should only be given at night when it 
can be avoided during the day. I prefer, however, 
to use these opiates in the form of an injection into 
the bowels. For a child, three years old, five drops 
of laudanum mixed with a tablespoonful of starch 
water and injected slowly once in six or eight hours, 
and retained as long as possible. If rejected im- 
mediately it should be repeated sooner, and care is 
necessary not to hurt the intestine while using the 
injection. 

Diet is of the greatest importance in this disease 
and no solid food is to be permitted. If there is 
nausea and irritation of the stomach lime water 
and milk in about the proportion of one part of 
the former to eight of the latter. If the stomach 
will accept it, beef tea, oysters, mutton broth, boiled 
milk, soft boiled rice, tea, tapioca, etc.; if prostra- 
tion is extreme, milk punch. To allay the thirst 
permit small pieces of ice to slowly dissolve in t-he 
mouth ; this is far better than copious draughts of 
any liquid. 

The whole body should be frequently sponged 
with warm water made alkaline with a little soda. 



424 PAINLESS CIIILDBIIITIL 

Warm fermentations of hops over the abdomen 
will often afford material relief They must be 
light and never be wet enough to drip. The sick 
chamber should be kept will ventilated, and disin- 
fected with carbolic acid daily, and the discharges 
from the bowels must be removed at once, and 
thoroughly disinfected or buried. 

ACUTE INTESTINAL CATARRH. 

This disease, also called maco-enteritis, is an in- 
flammation of the mucous membrane of the small 
intestine, and occupies a position between diarrhoea 
on the one hand and dysentery on the other, par- 
taking to some extent of the nature of both. It 
may result from cold, or the irritation of particles 
of undigested food, or from other causes of intesti- 
nal troubles. It may extend upward and involve 
the stomach, or downward to the large intestine. 

Symptoms.— Muco enteitis generally begins 
with pain and tenderness about the naval, griping 
and a frequent desire to evacuate the bowels. There 
is diarrhoea, but whether the evacuations be large 
or small they do not relieve the desire to go to stool. 
The evacuations vary, sometimes yellowish, thin, 
acrid, and mixed with mucus and sometimes ting(d 
with blood. If the stomach is involved there will 
be vomiting. If it extends to the lar^e intestine 
there will be the straining characteristic of d}S- 
entery. There is languor and chilliness, or perhaps 
a severe chill, fever, and pain about the naval, the 



DISEASES OF CHILDREN. 425 

appetite is lost, the tongue coated with a yellowish 
far, and in the severer cases, it is dry with redness 
of the tip and edges. In some cases the prostra- 
tion is great, and typhoid symptoms develop, pres- 
sure on the bowels reveals tenderness and pain, 
the stools are variable, the desire irresistible, yet 
perhaps very little or nothing passes. 

Treatment. — The use of the popular " diarrhoea 
medicines" in these cases are often worse than 
nothing, frequently aggravating the disease. The 
function of the skin should be re established as 
soon as possible, and for this purpose a vapor bath 
or even a warm bath should be employed at the 
commencement. The patient should then be put 
into a warm bed and moderate perspiration pro- 
moted, care being taken, when getting up to evacu- 
ate the bowels, to be well wrapped to prevent 
taking cold I then give : 

Tincture of Aconite Boot, - - 10 drops. 
Fluid Extract of Ipecac, - - 10 drops. 

Water, 4 ounces. 

Dose — A teaspoonf ul every hour or two. Alternate this with : 

Fluid Extract of Mandrake, - 10 drops. 

Water, 4 ounces. 

Dose — A teaspoonf ul every two to four hours, between the 
other doses, and continue it until the discharges become more 
natural in appearance and consistence. 

If there is much blood in the stools with mucus 
and severe straining, in place of the mandrake I 
would give : 

Corrosive Sublimate, % grain. 

Water, 8 ounces. 

Dose — A teaspoonf ul every four hours. 



426 PAINLESS CHILDBIRTH. 

Counter-irritation over ihe bowels with mustard 
or with turpentine applied a few moments at a time 
on a cloth, answers a good purpose in many cases. 

The thirst which is sometimes extreme may be 
allayed by allowing small pieces of ice to melt in 
the mouth, and will not aggravate the diarrhoea as 
large quantities of fluids are apt to do. The diet 
must be light and no solid food allowed, beef tea, 
mutton broth, boiled milk, soft boiled rice, soft 
toast, tea, etc. The warm sponge bath should be 
repeated two or three times a day. As a rule 
opiates do not act kindly in these cases. 

Usually this treatment will produce a very favor- 
able impression in two or three days, but care 
must be observed, for the disease is extremely lia- 
ble to relapse, even after the discharges have had a 
natural appearance for several days. When a 
relapse occurs it necessitates a repetition of the 
treatment, in which case it is to be supplemented 
with a few doses of quinine, proportioned to age, 
given after the active symptoms have declined. 
This is more particularly demanded when malarial 
influences exist. A looseness of the bowels some- 
times remains that will demand the administration 
of astringents. For this purpose two to five drop 
doses of fluid extract of cranesbill is one of our best 
remedies, and may be repeated two to four times a 
day. A pure article of Hungarian wine answers 
an excellent purpose, combining as it does an ex- 
cellent astringent with a mild stimulant, it must 



DISEASES OF CHILDREN. 427 

however be used cautiously, or it will induce con- 
stipation that may be followed by a relapse. An 
influsion of red raspberry leaves answers well. 
Blackberry cordial, or an infusion of the black- 
berry root are agreeable astringents, and some of 
them are always within reach, 

CHOLERA MORBUS. 

This is an acute disease characterized by vomit- 
ing and purging, associated with derangement of 
the functions of the liver. It may occur at any 
period of the year, but is most frequently met with 
in the latter part of summer and autumn, and pre- 
vails more extensively some years than others. 
The influence of extreme heat upon the functions 
of the liver is a powerful predisposing cause. Sud- 
den changes in the weather, eating improper food? 
unripe vegetables and fruits, of which cucumbers, 
green apples and plums, are most deserving of 
mention ; drinking freely of icewater when over- 
heated, ice cream, impure milk, etc., etc., are the 
most frequent exciting causes. 

Symptoms* — In a large per cent, of cases it 
will be ascertained on careful inquiry that there 
has been present, for a few hours or days, some de- 
rangement of the stomach, nausea, coated tongue, 
flatulence, with a sense of weight, and oppression, 
as if some of the food eaten remained in the stom- 
ach undergoing fermentation instead of being 
digested, sometimes accompanied by diarrhoea. 



428 PAINLESS CHILDBIRTH. 

These premonitory symptoms are not always pres- 
ent or are so mild as to attract little or no attention. 
The real attack generally comes on suddenly and 
violently, sometimes a severe chill wakens the pa- 
tient from a sound sleep, soon to be followed by a 
pain in the bowels, nausea, vomiting and purging. 
At first the matter vomited will consist of partly 
digested food, mixed with mucus, and a dirty yel- 
lowish or greenish fluid, and the discharge from 
the bow r els will consist of ordinary feces mixed with 
a similar matter as that ejected from the stomach. 
The discharges become more fluid as the disease 
goes on, containing for a time more or less vitiated 
bile. In severe cases the discharges soon take on 
the characteristic "rice water" appearance of Asi- 
atic cholera. The discharges are profuse, frequent, 
and sudden, and rapidly exhaust the patient, so 
that he becomes so weak as to scarcely be able to 
move in bed. The weight of the body is rapidly 
reduced. There is a terrible thirst present, but 
drinks are rejected almost as soon as swallowed. 
Spasmodic contractions of the muscles of the lower 
extremities frequently occur, and sometimes the 
abdominal muscles are involved. The?e cramps 
are exceedingly painful. JThe pulse is small and 
frequent, the surface cold and bathed with a cold 
perspiration, the face appears blue and pinched. 
If relief is not obtained the prostration is increased, 
the mind wandeis, insensibility and collapse occur 
to end in death. The disease lasts from a few 



DISEASES OF CHILDREN. 429 

hours to two or three days, but sometimes it is fol- 
lowed by a secondary fever, lasting a week or more. 
Usually the disease is easily recognized, and in the 
majority of cases, particularly with proper manage- 
ment, recovery takes place. 

Treatment. — The irritable condition of the stom- 
ach demands attention. The time was w T hen emetics 
were regarded as about the only thing capable of 
accomplishing this object, but alas! how mankind 
changes. Emetics are no longer the fashion, and we 
seek to accomplish the same end by entirely differ- 
ent means, and we suggest : 

Fluid Extract of Ipecac. - - 5 drops. 

Fluid Extract of Veratrurn, - - 5 drops. 

Water, 4 ounces. 

Dose — A teaspoonful every ten minutes. 

Apply over the stomach a mustard paste or plas- 
ter, and keep it on until the skin is considerably red- 
dened. Apply dry warmth to the extremities, brisk 
rubbing, with or without dry mustard, will aid in 
stimulating the circulation and relieving the cramps. 
Endeavor to restore warmth to the surface. Do not 
permit large draughts of any fluid, but allay the 
thirst by allowing small bits of ice to melt in the 
mouth. Give internally : 

Tincture of Camphor, ... 1 dram. 

Essence of Peppermint, - - % dram. 

Essence of Jamaica Ginger, - - 1 dram. 

Chloroform, 1 dram. 

Brandy to make two ounces. 
T>( s ■> — Five to fifteen drops according to the age of the child. 
with larger doses for adults, given in hot water sweetened, and 
repeated every fifteen to thirty minutes, oftener if rejected. 
At the same tim? continue the ipecac and veratrurn. 



430 PAINLESS CHILDBIRTH. 

This prescription alone, is a powerful stimulant 
to the nervous system, aids in controlling the vom- 
iting and diarrhoea, relieves the cramps in the ex- 
tremeties, and fulfills most of the indications that 
call for medicine in the disease. 

When the stomach has been brought under con- 
trol, we may use the following for the liver : 

Tincture of Leptandra, - - - 1 dram. 

Aromatic Syrup Rhubarb, - - 1 ounce. 
Dose — A teaspoonful every two or three hours until bile is 
seen in the stools, and they begin to appear natural again. This 
dose is for a child from five to ten years old. 

Fricton and dry warmth to the extremeties must 
not be overlooked for this and cholera are the. dis- 
eases above all others in which "heat is life." 

Sometimes the vomiting is very obstinate. If it 
does not yield to the measures already advised in a 
short time, other means should be employed. Iced 
champagne will sometimes succeed. An infusion 
of peach leaves, is efficient in some cases. Or if it 
can he procured the compound tincture of cajeput 
in 15 to 20 drop doses every quarter or half hour, is 
one of the best remedies. It is best taken on a little 
sugar. If collapse threatens, artificial warmth and 
stimulants, and two drops ^each of the tincture of 
camphor and cayenne in water every ten or fifteen 
minutes. Inhalation of ammonia, is also beneficial, 
if necessary, persevere with these means, and many 
apparently hopeless cases will be restored to health. 

After the acute symptoms are over, there will re- 



DISEASES OF CHILDREN. 431 

maiirfe debility and prostration which may be met 
with the following : 

Tincture of Cinchona Compound, - % ounce. 
Tincture of Nux Vomica, - - 20 drops. 
Simple Elixir to make four ounces. 
Dose — One-half to one teaspoonf ul three times a day, larger 
doses for grown persons. 

Convalesence is usually rapid. 

CHOLERA INFANTUM. 

This disease, popularly termed the " summer com- 
plaint of children," is one of the greatest foes of 
infancy, and is one of the most difficult diseases we 
are called upon to treat. It prevails more exten- 
sively in cities and towns than in the country, and 
is usually met with in the first and second years of 
a child's existence. There are several varieties of the 
disease, a fact that has occasioned much diversity of 
opinion ; and as any attempt to distinguish the dif- 
ferent types of the disease could only result in con- 
fusing the readers, I will omit it. 

There is serious- perversion of the nutritive func- 
tions, with vomiting and diarrhoea, sometimes acute 
at others chronic, sometimes accompanied by fever 
and sometimes without. 

Causes. — Impure food,, the heat of summer, bad 
water, bad air, un by genie surroundings, irritation 
of the nervous system from teething, etc., all con- 
tribute to the production of the disease. Frequently 
several of these causes are combined. The country 
districts present decided advantages for children ; 



432 PAINLESS CHILDBIRTH. 

ther the heat is not usually so intense or continu- 
ous ; the ventilation is better ; the water pure and 
not poisoned by the conductors it traverses ; the 
milk is better, unmixed, and unadulterated, and 
not subjected to the natural changes that occur in 
it on account of time after leaving the cow, and the 
agitation of transportation; vegetable food is ob- 
tained before it undergoes retrograde metamorphosis. 
The opportunities for out door exercises are greater, 
etc. The disease frequently occurs about the time 
of weaning, or when young children are subjected 
to a change of food, which combined with other 
causes are sufficient to develop it. Even when fed 
upon its mother's or the nurse's milk, unhygenic sur- 
rounding?, dietetic or sexual imprudence may cause 
such a change in the milk as to be exceedingly dele- 
terious to the child, and thus aided by other causes, 
induce an attack of this disease. The mother's or 
nurse's milk even while plentiful, may be so impure 
or impoverished, as to be a sourse of the disease. 

Nursing bottles, unless cleansed at regular inter- 
vals with the greatest care, develop disease germs 
with great rapidity, and are a great abomination. 
The more complicated they are, the more difficult 
they will be to cleanse, and consequently the worse 
for the child. Impure air, often the result of decay- 
ing matters, pregnant with disease germs is not 
backward in its contributions to the developement 
ol the scourge. 

Symptoms. — Necessarily the symptoms of this 



DISEASES OF CHILDREN. 433 

disease vary. Vomiting and diarrhoea, however 
being present in all cases, but in variable severity. 
These with the intense thirst, the great prostration 
and rapid emaciation, furnish us with means of 
diagnosis however much the other symptoms may 
vary. There may be an increased irritability of the 
child, with diarrhoea, for several days, but attracting 
little attention. This may increase slowly, the nau- 
sea, vomiting and thirst, gradually developing. In 
other cases the attack comes on suddenly and is 
severe at the outset. 

The passage from the bowels at first contain fecal 
matter, little odor, or perhaps a sour smell, but as a 
rule they are very offensive, the odor sometimes 
penetrating every part of the house. The stools 
frequently contain partially digested food, mixed 
with stringy mucus, yellowish, greenish, or clayey in 
color, or are perhaps almost white, with curds of 
undigested milk, and sometimes streaked with 
blood. In other cases the stools are watery, and it 
is not unusual to see them change rapidly, present- 
ing all these peculiarities in turn. The thirst is 
intolerable, incessant, and the fluids taken are 
almost immediately rejected or discharged by the 
bowels. The child is uneasy, restless, never satisfied, 
desiring constant change, or it may lie semi-stupe- 
fied, roused at intervals by paroxysms of pain that 
seem to resemble the pains of cholera morbus, the 
child suddenly screaming and then lapsing into the 
stupor again. 



434 PAINLESS CHILDBIRTH. 

The nervous system is very irritable, and often dis- 
ease of the brain complicates the case. 

As the disease progresses the eyes become sunken 
and partially closed, the lips are dry, parched, 
bleeding, the countenance pale, the skin dry and 
pinched, and rapid emaciation takes place. The 
bowels are tender. An eruption often appears upon 
the buttocks, or excoriated by the discharges, con- 
tact with the stools or urine occasion, great smarting 
and pain, is materially added to the child's suffering. 

The pulse is mall, quick, tense; the tongue at first 
coated with a whitish fur, becomes dry and glossy. 
All the symptoms are generally worse at night, and 
a remission towards morning apt to occur, hut rapid 
changes are likely to take place at any time. 

When the brain is affected, the head becone^ 
hot and is rolled from side to side, or the child sinks 
into a stupor, the eyes rolled upwards, the lids but 
partially closed, the pupils dilate and do not con- 
tract on exposure to the light. 

There may be as many as fifty stools in twenty - 
four hours, but as a consequence, when so frequent, 
the quantity ateach passage will necessarily be small. 

Some times the disease assumes a more chronic 
form and the symptoms are not so severe, and some 
of them may be absent, but the vomiting and diar- 
rhoea reduce the child to a skeleton, the skin be- 
comes dark and harsh with livid spots, the mouth 
filled with apthous ulcerations, the tongue swollen 
or perhaps shrunken, and the stools acrid and 



DISEASES OF CHILDREN. 435 

offensive. hi such cases acute symptoms, or dis- 
ease of the brain are sometimes developed and 
destroy the child. The disease may last from three 
days to two weeks, leaving the child in a broken 
down condition from which it will require months 
to recover In others, the alternate periods of get- 
ting better and worse will protract the case for 
weeks and even months. Absolute safety from a 
relapse is never certain until the warm season is 
passed, and the cool weather is accompanied with a 
complete convalescence ; and even then there is no 
immunity against a recurrence the next season, ex- 
cept the child be over two years old, when there is 
comparative safety. 

Treatment.— Reference to medical writings will 
convince the reader that the profession is at sea in 
this complaint, and it is no wonder with this expe- 
rience many prefer to rely on the'nursing and care 
of "grandma" or " aunty " instead of resorting to 
" doctor's stuff/' 

Pure air is essential, and a removal to the country, 
particularly an elevated situation, is desirable. This 
cm not always be done, and in cities every effort 
should be made to render the air as pure as possi- 
ble, by the removal of every thing offensive; avoid, 
dark, damp rooms, and secure plenty of sunshine, 
even though the heat has to be modified by shades, 
but with the sunshine secure constantly changing 
air. Allay the inordinate thirst by a spoonful of 
cold water often repeated, it is very grateful, and 



43(5 PAINLESS GlIILBBTllTIL 

though too much will be rejected, small quantities 
repeated often are generally acceptable. Small 
bits of ice dissolved in the mouth are beneficial. 
The ice must be clear and pure ; repeat the bits 
often ; break them so fine that if swallowed they 
will not do any harm. 

Food must be given with caution. The mother's 
milk, if there is no reason to withhold it, is the 
best food for a nursing child, but it must be permitted 
sparingly, and only at stated intervals. It should 
be remembered that the child will often take the 
breast or bottle eagerly on account of thirst instead 
of hunger, and that water is far preferable to food 
to quench that terrible want. A spoonful of water 
under such circumstances, affords the child far 
greater satisfaction, and does far more good than 
to feed it. 

If cow's milk is the diet, be particular to secure 
only that which is pure. It is to be preferred from 
one cow only, and should not be over twelve hours 
old if it is possible to obtain it twice a da}'. People 
living in t'he country have a decided advantage in 
this respect. Lime water may be added to milk 
advantageously in the proportion of an ounce to a 
pint. See that the nursing bottle is thoroughly 
cleansed and scalded after each feeding. Diminish 
the quantity of food from that taken before the 
sickness began, and only give it at intervals of two 
to four hours. Sometimes the milk will be rejected 
by the stomach because it is too rich in fatty matter, 



DISEASES OF CHILDREN. 437 

in such cases skim it, bat do not go to the other ex- 
treme and starve the child on the shadow of milk. 

The juice of raw meat is sometimes very accept- 
able, and better than milk, add a little salt to it to 
make it palatable and give half to one teaspoonful 
every two hours Carefully watch all food and if 
it disagrees set it aside. I have seen weak mutton 
broth agree nicely sometimes when other food was 
rejected. I have seen skimmed milk accepted and 
agree well when unskimmed was loathed and 
rejected. This is not apt to happen in cities. There 
are many artificial foods in the market, of their 
relative value I am not prepared to speak. When 
tried it should be cautiously and under advisement 
of a physician. The digestive process being almost 
wholly, if not quite, suspended, there is usually 
more danger of over feeding than starving the 
child. Small quantities, digested, do good, but 
large amounts are apt to undergo fermentation 
and add to the existing trouble 

Bathing is not to be omitted. If the child is 
feverish, restless, thirsty, tepid bathing is decidedly 
beneficial and should be repeated several times in 
twenty-four hours. A sponge bath is most proper, 
and care should be observed that the clothing is 
not left wet. 

The removal of the discharges from the bowels 
should be effected immediately and disposed of so 
that no smell is left behind. As the buttocks are 
very apt to get sore, a little vaseline rubbed on the 



438 PAINLESS CHILDBI11TIL 

parts each time the change is made will afford pro- 
tection. Powdered starch or lycopodium is also 
good, and may he freely dusted on. 

For medicine if there is fever with diarrhoea and 
vomiting give : 

Tincture of Aconite Root, - - 5 drops. 
Fluid Extract Ipecac, ... 5 drops. 
Water (one-half goblet), - 4 ounces. 

Dose — A teaspoonf ul every half hour and as the fever abates 
lengthen the interval. Alternate with : 

Fluid Extract Nux Vomica, - - 2 drops. 

Water, 4 ounces. 

Dose — A teaspoonful every hour or two. 

If instead of fever there is great prostration, cold 
extremities, vomiting, redness of the eyes and tip 
of the tongue, stools offensive and acrid, change 
the prescriptions and give : 

Fluid Extract of Ipecac, - - 5 drops. 

Fluid Extract of Nux Vomica, - 2 drops. 

Water, (one-half goblet) - - 4 ounces. 
Dose — A teaspoonful every hour, and mix ten drops of the 
second or third homeopathic dilution of arsenicum, in half a 
glass of water and give a teaspoonful every three or four hours, 
between the doses of the ipecac and nux. If this preparation of 
arsenicum can not be had, substitute five drops of Fowler's solu- 
tion in one-half glass of water and give in the same manner. 

In alternation with the ipecac and nux, the neu- 
tralizing cordial of the eclectic school is in great 
favor with many. I esteem it highly if the tongue 
is moist with a whitish fur, the matter vomited 
sour, or the stools clay colored, sour or curdy. For 



DISEASES OF CHILDREN. 439 

these cases I prepare it thus and consider it better 
than the usual preparation on account of the omis- 
sion of the sugar, which is always in the prepara- 
tion as usually obtained : 

Pulverized Peppermint Leaves, - % dram. 

Pulverized Rhubarb Root, - - 1 dram. 

Bi-carbonate of Soda, 1 dram. 

Boiling Water, .... 4 ounces. 
Cover, let it stand until cool, strain and add half an ounce best 
brandy, and give in teaspoonful doses every hour until its pecu- 
liar color is seen in the stools, then give it three times a day. 
The addition of one-half grain of subnitrate of bismuth in each 
dose often materially enhances its value. 

When we have the vomiting under control, we 
have gained an important point. If the stools are 
copious, watery, offensive and apparently painless, 
while keeping on with the ipecac and nux I would 
give two to five drops of the compound tincture of 
cinchona, every three hours in a teaspoonful of 
water. When the discharges begin to yield lengthen 
the intervals between the doses. 

Jf the trouble depends on irritation from teething, 
and the gums are hot and swollen, lance them, and 
give in alternation with the neutralizing cordial 
above : 

Fluid Extract Gelsemium, - - 10 drops. 
Water, (one-half goblet) - - 4 ounces. 
Dose — A teaspoonful every hour or two until the irritation of 
the nervous system is relieved. 

The use of pepsin in grain doses just before or 
after the feeding will aid the digestion of the food 



440 PAINLESS CHILDBIRTH. 

taken at that time, and is a valuable auxiliary to 
other means. 

After the urgent symptoms are passed, a loose- 
ness of the bowels, or a feebleness of the digestion 
often remains. In such cases continue the pepsin 
at the time of feeding, and also give three to five 
drops of compound tincture of cinchona in a 
spoonful of water about four times a day. This 
however may be replaced by hydrastis in some 
form or other, of which the fluid, without alcohol, 
five drops in two ounces of water given in tea- 
spoonful doses three or four times a day, answers a 
good purpose. 

I might add fifty or more other remedies to the 
above, but as they would be more apt to mislead 
than aid, I omit them. Many cases will occur, 
which, in the judgment of the attending physician 
require that other remedies should be given. In 
selecting but the few, I have endeavored to follow 
the principle of " the greatest good to the greatest 
number/' and have consequently outlined the 
treatment I have found most serviceable in general 
practice. 

EPHEMERAL FEVER. 

Childhood is liable to a form of fever that has 
been termed febricula, or ephemeral fever, on ac 
count of its short duration. It lasts but two or 
three days as a rule but in some cases is protracted to 
six or even ten. Although of short duration the 



DISEASES OF CHILDREN. 441 

fever is often intense. It is not accompanied by 
any of the characteristics that distinguish other 
fevers. It is due in the majoritj^ of cases to expos- 
ure to extremes of heat or cold, improper food, 
exhaustion, intestinal irritation, etc., or several of 
these causes combined. 

Symptoms. — Ephemeral fever begins abruptly. 
There will be lassitude, with chilliness, the child 
will complain of feeling unwell, perhaps lie down, 
and wake up from a short nap with a raging fever, 
pulse quick and full, temperature high, tongue cov- 
ered with a whitish fur, thirst, headache, sometimes 
restlessness, sometimes drowsiness, with pain in the 
limbs, bowels costive, the urine in some cases scanty 
and in others profuse. The skin may be hot and 
dry at first, while sometimes there is profuse per- 
spiration. All these symptoms may terminate 
within twenty four hours or they may last two or 
three days. Often it terminates with profuse per- 
spiration. 

Treatment. — Many cases terminate without any 
treatment at all. I would however advise that, 
whenever it continues beyond a few hours, bathing 
with water at a temperature most agreeable to the 
patient be repeated every three or four hours, using 
a sponge or towel bath. 

Open the bowels with a small dose of a saline 
cathartic as calcined magnesia, seidlitz powder, 



442 PAINLESS CHILDBIRTH. 

Rochelle salts, or effervescing citrate of magnesia. 
Then give : 

Fluid Extract of Aconite, - - 5 drops. 

Fluid Extract of Gelsemium, - 10 drops. 

Water, 4 ounces. 

Dose — A teaspoonf ul every hour or two. 

Allay the thirst with lemonade, seltzer, or any of 
the carbonated waters, and let the diet be light. 
This plan will modify the severity of the fever and 
contribute to a speedy recovery. 

WORMS. 

Several varieties of worms infest the intestinal 
canal, but children are specially liable to the round 
or stomach worm, and the small white or pin worm. 

The symptoms they occasion are variable; usu- 
ally there is mal-nutrition, and a catarrhal condi- 
tion of the bowels, plenty of mucus being favorable 
to their development. The appetite is capricious, 
sometimes absent and sometimes voracious, the 
breath offensive, acrid eructations, colicky pains 
about the navel, sometimes vomiting and diarrhoe., 
slimy stools, profuse urine, grinding the teeth, sud- 
den starting in the sleep, picking the nose, fever, 
emaciation, hacking cough, irregular pulse, and 
sometimes convulsions. 

In addition to these symptoms, when pin worms 
infest the lower bowel, there will be an intolerable 
itching of the anus, with slimy stools, etc. All 
these symptoms may be present, and yet we cannot 



DISEASES OF CHILDREN. 443 

be absolutely certain that they are due to worms, 
unless we see them, or pieces of them, in the stools. 
Occasionally, however, they will be vomited up o; 
crawl from the mouth. In little girls, pin worms 
will sometimes find their way from the rectum 
into the vagina, and give rise to troublesome itching 
and leucorrhoea, and sometimes irritation of the 
bladder. 

Treatment. — The indications are to destroy the 
parasites, and improve the condition of the intesti- 
nal tract so as to prevent their reproduction. 
Worms are exceedingl}' prolific, and children of a 
scrofulous disposition, and those indulged in an 
excess of sweets or fed on unwholesome food, will 
be very apt to suffer from frequent repetition of the 
symptom, sunless the treatment to destroy them is 
repeated at intervals, and an improvement in the 
intestinal condition effected. For the first indica- 
tion we have several remedies, even the common 
pumpkin seed is a good one. It may be eaten by 
the children, or steeped and the tea drank. Tie 
old fashioned infusion of pink root, and senna, was 
an effectual remedy. Turpentine fulfills the ind- 
ention well, fifteen to twenty drops of spirits of tur- 
pentine in a dose of castor oil repeated every third 
day does well. Salt water gives temporary relief. 
I like the following : Take 



Santonine, 


- 10 grains. 


Podophyllin, 


2 grains. 


Bi-carbonate of Soda, 


- 30 grains. 


Sugar, - - - 


1 dram. 



444 PAINLESS CHILDBIRTH. 

Triturate thoroughly and divide into ten powders. To a child 
from two to four years old, give one-half a powder three times a 
day when the stomach is empty ; for a child five to seven years 
old give a whole powder at a dose. Repeat daily for two or 
three days in succession until the podophyllin causes a looseness 
of the bowels, then omit for a week, and repeat the process. In 
a couple of weeks repeat again. 4)uring the intervals give a 
bitter tonic, of which I prefer grain doses of salicin, three times 
a day, or ten to fifteen drops of compound tincture of gentian 
in water before meals. 

I have seen this plan do wonders for children 
sometimes. When convulsions occur, in addition 
to the use of the ll worm medicine/' give such treat- 
ment as is advised under the head of convulsions. 

The pin worms infest the lower bowel, and rem- 
edies administered by the mouth are of little 
consequence. To effectually destroy them, it is 
necessary to apply the remedies directly. Injections 
are required, and a strong solution of salt and water 
is very effectual. An infusion of quassia chips is 
good, or fifteen drops of carbolic acid in a goblet of 
warm water may be used. 

Whichever injection is selected should be used 
after the turpentine and oil, or santonine and pod 
ophyllin have acted on the bowels, and it should 
be repeated every two or three days until they are 
entirely destroyed. In using injections, let the 
quantity be sufficient to distend the folds of mucous 
membrane of the rectum, and reach all the hiding 
places of the parasites or they will speedily be re- 
produced. At least half a pint should be used at a 
time, but not sufficient to distend the bow r els so 



DISEASES OF CHILDREN. 445 

much as to cause the child severe pain. The injec- 
tion is to be retained a few minutes if possible. 

This plan of treatment, simple as it may seem to 
some, will be found efficacious, and has the advan- 
tage of being available under nearly all circum- 
stances. 

Although we have already exceeded the intended 
scope of the present edition, the author realizes that 
there are many other subjects deserving considera- 
tion that must, be left to the future. Still if the 
directions already given shall enable woman to 
find even partial relief from sickness and pain, and 
render her assistance in the preservation of her 
darlings, and the promotion of their welfare, his 
object will have been accomplished. 




446 PAINLESS CHILDBIRTH. 



NEUTRALIZING MIXTURE. 

This valuable preparation, so much in use by the eclectic 
school, for dysentery, cholera morbus, diarrhoea, vomiting, etc., 
is variously prepared by different physicians. The following 
formula will be found convenient and efficacious. The pulver- 
ized peppermint leaves, from the plant gathered fresh each year, 
will be found preferable to the oil or essence. Take, 

Indian or Turkey Rhubarb, - 1 ounce. 
Bi-carbonate of Potassa, - - 1 ounce. 
Peppermint Leaves, Pulverized, - J^ ounce. 

Mix. Put it in a covered stone or porcelain jar, and add a 
pint of boiling water. When cold add one-half pint of best brandy 
and one-half pound of loaf sugar. Let it stand a day or two 
and then strain through cloth, and bottle. 

Dose — For an adult a tablespoonful every half hour. For a 
child two to four years old a teaspoonful every two hours. 

Some add cinnamon and cloves to the above formula, but I do 
do not know that they increase its efficacy. 

The bi-carbonate of soda may be substituted for the potassa if 
necessary. 

Mother's will find this an excellent preparation to have at 
hand for the stomach and intestinal disorders to which every- 
one, large and small are liable. It will keep indefinitely. On 
page four hundred and eighteen I have given a prescription for its 
extemporaneous prepration, but this is to be preferred if at hand. 

SQUAW VINE COMPOUND. 

On page ninety-seven appears directions for the preparation 
of this plant with the blue cohosh. As the black cohosh may be 
added to it and all taken together during the last months of 
pregnancy, many will prefer to prepare the whole at once 



DISEASES OF CHILDREN. 447 

rather than to steep a little daily as I have elsewhere advised. 
For this purpose the addition of alcohol in some form will be 
found necessary to preserve the mixture during its use. The 
following will be convenient. Take : 

Squaw Yine, % pound. 

Blue Cohosh, - 3€ pound. 

Black Cohosh, .... 3^ pound. 

Bruise all together and steep it slowly in two quarts of water 
in a closed vessel for twenty-four hours, keeping up the quantity 
of liquid, by adding from time to time as much water as is lost 
by evaporation. Then press out and strain through cloth, and 
reduce the liquid by evaporating at a general heat, to three pints ; 
add one pound of loaf sugar, and when cold a pint of best whisky 
or gin. A small quantity of essence of wintergreen may be 
added as a flavor if desired. Bottle, cork tight and keep in a 
cool place. It will be better to put it in several small bottles 
than one large one, so that but a small quantity is opened to the 
air while taking it. 

Dose — A tablespoonf ul four or five times a day. 

When there is an unusually irritable condition of the nervous 
system, and particularly the uterus, with a disposition to miscar- 
riage, the addition of one-fourth pound of cramp bark (vebur- 
num) to the above compound will be advantageous. This of 
course must be done while steeping. When added no change 
will be necessary in the dose. 



448 



PAINLESS G1ULDBIRT1I. 



INDEX. 



Abnormal development, - 231 

Abscess of the Breast, - 192 

Acrid vaginal discharge, - 236 

Acute intestinal catarrh, - 426 

Afterbirth, Kemoval of, - 173 

" Disposition of, - 176 

After delivery, Management, 177 

After pains, - - - 184 

Age of wife, - - - 37 

Ammenorrhcea, - - 251 

A mistaken notion, - 37, 89 

Anaesthetics, - - 142 

" Dangers of, - - 142 

" How to use, - 146 

11 Objections to, - 146 

" Popular opinions, - 149 

" Statistics of, - - 144 

" Views of physici's,148-151 

An Indian tradition, - 93 

Appetite morbid, - - 109 

A practical conclusion, - 43 

Apthae, - - - - 333 

Attention to the child, - 174 

Attention to the mother, - 177 

Attitude in disease, - 321 

Attributes of man. - 17 

Bandage, The - 157-159 

Bathing, - - 74 

" Dr. Shew on - - 77 

u Children, - - 206 

Baths, .... 76 

Barrenness, - - - 220 

Beer and malt liquors, - 199 

Black cohosh, - 98 

Bladder, Irritation of - 140 

Bloody flux, - - 420 

Blue cohosh, - - 95 

Bone forming diet, - 86 

Bony development of child, 6Q 

Breasts, - - 313 

" Abscess of - - 315 

" Arrested development 314 

" Cancer of - 316 

" Inflammation of - 314 



Cancer, - - 302 

Canker, - - 333 

Causes of pain, - - 58 

Causes of sterility, - 222-229 

Cerebro-spinal meningitis, 386 

Changes in pregnancy, - 40 

Change of Life, - - 304 

Chicken pox, - - 392 

Child, Attention to - 174 

" Its bowels, - - 210 

" Delay in breathing, - 171 

" Its urine, - - 211 

" Washing and dressing, 175 

Chloroform, - - 143 

Cholera Infantum, - 431 

Morbus, - - 427 

Chronic Pneumonia, - 353 

" Inflammation of womb,272 

Circulation in children, - 324 

Cohosh, Black - 98 

Blue - - - 95 

Colds, - - - 335 

Colic, Infantile - 215 

Colustrum, - - 195 

Composition of bone, - 82 

of food, - 81 

Conception, Philosophy of 224 

Prevention of 33, 237 

Congestion, Ovarian - 311 

Constipation, - 100, 114 

Consumption, 355 

Convalescence after birth, 181 

Convulsions, - - 141, 330 

Cord, Umbilical - - 170 

Couch for labor, - - 158 

Cough, - - 118 

Countenance in disease, - 320 

Cow's milk, - - 197 

Cramps, - - 125 

Croup, - - - 340 

Curvature of neck of womb, 213 

Deformities, - - - 62 

Delav in child's breathing, - 171 

Diarrhoea, - - 116, 415 



DISEASES OF CHILDREN. 



449 



Dietetic measures, - - 81 

Diet in infancy, - 201 

Difference in suffering, - ^49 

Diphtheria, . - 378 

Diseases that cause sterility, 222 

" of children, - - 318 

fc « of women, - - 249 

" of women, cause of - 62, 250 

" of women, fashionable -275 

Discharges in disease, - 322 

Dispensation of Providence, - 47 

Disposition to miscarry, - 126 

Displacement of woml>, - 286 

Doses for children. - • 319 

Dress, Influence of - - 178 

Dressing the child, - - 175 

Duration of labor, - - 56 

Dysentery, - - 420 

Dysmenorrhea, - • 257 

" Inflammatory, - - 259 

" Mechanical, - - 263 

" Membraneous, - 238, 260 

" Neuralgic, - - 257 

Early marriages, - " 39 

Effect of child's condition on 

pain, - - - - 65 
Effect of lacing, - - 60 
Elongation of neck of womb, 233 
Ephemeral fever, - 440 

Enteritis mucous, - - 426 
Erysipelas, - - 411 

Excoriations, - - 326 

" of nipples, - 191 
Exercise, - - - 72 

Expression of Countenance, - 320 
Eyes, inflammation of - 212 
Failure of kidneys, - - 188 
Fainting, - 123 

Falling of womb, - - 287 
False pains, - - 161 

Fecundity, period of,Duncan, 242 
Feeding and physiciug, - 194 
Fever, Ephemeral - - 440 
Fever, Milk - 183, 190 

Fever, Scarlet - - 403 

Flatulence, - - 180 

Flooding - - 131, 173, 178 
Formation of bone, - - 216 
General signs of disease, - 319 
Gestures in disease, - - 321 
Headache, - 120 

Healthy organs painless, - 51 
Heartburn, - - 112 

Hemorrhage after birth, - 173-178 
How much to eat, - - 89 



How to toughen children, - 205 
Husband and wife should sleep 

apart, - - - 79 

Hygienic management, - 70 
Hygiene, Object of 71 

Hymen, Imperforate - -226 
Imperforate Hymen, - 226 
Inadaptability, - - 247 

Incontinence of urine after 

labor, - - 188 

Indigestion of children, - 314 
Inflammation of the eyes, - 212 
i* of the lungs, - 347 

" of the womb, - 272 

Influenza, - - 336 

Instincts, Maternal, - - 30 
Intelligence of children, - 207 
Interests of man and woman, 2d 
Intestinal catarrh, Acute - 426 
Involution of the womb, - 180 
Irregular menstruation, - - 256 
Irritability of the bladder, 140, 281 
" of the womb, - 64 
Is pain necessary, - - 46 
Jaundice, ... 211 

Jolting, - - - 209 

Kidneys, Derangement of - 103 
" . Failure of - - 189 
Kinds of food, - -• 81 

Labor, Management of - 154 
" Preparation for - - 157 
" Symptoms of - - - 160 
Lacing, Effects of - - - - 60 
Lack of milk, - - 196 

Late marriages, - - 39 

Laws against preventing con- 
ception, 33 
Laws of being, - 26 
Laws of civilization, - - 33 
Leucorrhoaa, - 138, 267 
Light, 74 
Limitation of offspring, - 34 
Liver spots, ... 120 
Lochia, ... 181 
Longings, - - 109 
Love, ... 18 
Love's consummation is mar- 
riage, - - 20, 219 
Lung fever, - * 347 
Malt Liquors, - - 199 
Management after birth, - 177 
Management of labor, - 154 
Marriage, Love's consumma- 
tion, - - 20, 219 
Marriages, Early and late - 39 



450 



PAINLESS CHILDBIRTH, 



Maternity, - - - - 28 
Maternal' instincts, 30 

Matrimonial contracts, - 32 
Measles, - - - 398 

Membraneous dysmenor- 
rhea, - - - 238, 260 
Meu's desire for offspring, - 220 
Menorrhagia, - - 264 

Menses, Suppression of - 254 
Menstrual derangement, - 239 
Mil* fever, - - 183, 190 
Miscarriage, - - 127 

" Causes of - 129 

•' Consequences of 134 

" Hemorrhage in - 130 

" Management of - 132 

" Symptoms of - 132 

Modern customs, - - 59 

Morbid appetite, - - 109 

Morbid Irritability, - - 64 
Morning sickness, - ' 40. 104 
Moth, - - - 120 

Motherhood, - - 218 

Mother's cordial, - 97 

Mother's marks, - - 42 

Mother's milk, - • 196 

Muco-eute litis, - 426 

Mumps, - 369 

Muscular development, - 61 
Neither sex complete alone. - 20 
Neutralizing mixture, - 418, 446 
Neuralgic pains, - - 139 

Nervousness, - - 135 

Nipples, - - - 136 

Non-bony diet, - 87 

Nursing bottle, - - 197 

Nursing sore mouth, - 193 
Nursery discipline, - - 207 
Objects of hygiene, - - 70 
Occlusion of uterine canal, - 234 
Odors, - - - 325 

Ovarian congestion, - - 311 
Dcbilitv, - 23,') 

•« Diseises, - 241 

Painless childbirth proved, - 54 
Fains, True and F Use, - 161 
Ealpitatiou, - - 124 

Passion, - - - 20 

Peculiar function of women, 251 
Perineum, Support of - 16S 
Period of fertility, - 38, 242 
Pharyngitis, - - 372 

Pailopnogenitiveness, - 29 

Philosophy of conception, - 224 
Piles, 113 

Pneumonia, - - 317 



Pneumonia, Chronic, - 353 
Polypus, Uterine - 230,299 
Position during labor, - 165 
Position in treatment, - 294 
Preparation for labor, - 157 
Preparation for surgical opera- 
tion, 71 
Prevention of conception, 33, 237 
Pruritus, - - - 12L 
Pure air, 73 
Quinsy, - - - 375 
Reasoning powers, 18 
Regularity of nursing, - 198 
Regularity of feeding, - 202 
Regulating number of children, 34 
Remedial agencies, 91 
Remedies for constipation, 100, 114 
Remedies for kidney troubles, 103 
Replacement of uterus, - 291-293 
Retention of menses, - 251 
Retention of urine, - 186 
Retroversion of uterus, - 287 
Rocking the baby, - 209 
Rowbotham's idea, 83 
Scarlatina, - - 403 
Scarlet fever, - - 403 
Sex, Neither complete, - 20 
Sexual abuses, - - 221. 
Sexu d affections, - - 240 
Sexual attributes, - 17 
Shall woman control her func- 
tions, - - - 32 
Shew, Dr. on bathing, - 77 
Signs of diseases, - - 319 
Sitz baths, - - 76 
Sleep for the mother, - 77 
Sleep during infancy, - 199 
Smallpox, - - 392 
Sore nipples, - - 136 
Sore throat, - - 372 
Squaw vine, - - 93 
Squaw vine compound, - 97, 446 
Stages of labor, - - 166 
Sterility, - - - 218 
" Causes, - - 225 
Stricture of neck of womb,232,308 
Sub-involution, - - 296 
Summer complaint of children, 431 
Supporters, - - 290 
Surgical treatment of uterine 

diseases. - - 302 

Suspension of labor. - - 168 
Swelling of the extremities,95,124 
Teething, - - - 217 

Temperament in menstruation 306 
Temperamental incompati- 



DISEASES OF CHILDREN. 



451 



bility, - - 213 

Temperamental questions, - 245 
The bandage, - 157-159 

The couch, - - 158 

The cord, - - - 170 

The cry ia disease, - - 323 
The child, delay in breathing, 171 
The skin in disease, - - 321 
The temperature. - 325 

The tongue. - - 326 

Therapeutic agencies, - 92 

Thrush, - - - 333 

Too rapid delivery, - oQ 

Transmission of vitality, 21, 31, 12 
True labor pains, - - 162 
Tumors, - - 62. 229, 298, 313 
Turn of life, - - 301 

Ulcerations, - - - 327 
Umbilical cord, - - - 170 
Urine, The child's, - - 211 
Uterus compared with other 

organs, - - - - 50 
Uterine curvature, - - 231 
" Displacements, - 228, 286 
" Debility, - - 239 
" Inflammation, - 272 
" Polypi, - 230, 299 
" Stricture, - 232, 308 



Uterine tumors, - - 298 
Uterine ulceration, - - 283 
Vaginal discharges, - 138, 181, 207 
Vaginal lotions, ... 183 
Vaginismus, - - 309 

Varicose Veins, ... m 
Variety in diet, - - - 86 
Ventilation, 73 

Vicarious menstruation, - 267 
Vital Transmission, - 21, 31, 12 
Vomiting of children, - 213, 328 
Wakefulness, - - - 122 
WV.er for" the baby, - - 203 
Weaning, - 201 

Wet nurse, - - 197 

Weight at birth, - 65 

What pregnant women should 

avoid, - - -12 

What pregnant women should 

cultivate, 13 

Who suffer most, - - 53 
Whooping cough, - 361 

Why should women suffer, - 17 
Woman not always to blame 

for being sterile, - 213 

Woman's legitimate object, - 28 
Woman's peculiar function, - 258 
Worms, - - - 112 



